Five type I diabetic patients were followed prospectively during treatment with continuous subcutaneous insulin infusion by externally worn pumps and during the first 12 months after implantation of a remote-controlled insulin infusion device (ID1, Siemens AG). Stabilized insulin (Hoe 21 GH, Hoechst AG) was infused intravenously in two and intraperitoneally in three patients. Total observation time was 47.2 patient-months after implantation. Two devices had to be explanted prematurely, one because of a technical failure after 101 days, one due to a skin necrosis over the implant after 236 days. HbA1, frequency of hypoglycemia, total insulin dose, and basal rate infusion did not change after implantation. There was a reduction in the insulin antibodies 6 months after start of intravenous or intraperitoneal insulin delivery. Fasting plasma free insulin levels could be normalized only by intraperitoneal insulin infusion. Although a technical and a surgical problem was observed, our data show the successful implantation and clinical use of programmable dosing devices and stabilized insulin.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
continuous subcutaneous insulin infusion
continuous intravenous insulin infusion
continuous intraperitoneal insulin infusion
intensified conventional therapy
body mass index
van Ballegooie E, Hooymans JMM, Timmermann Z, Reitsma WD, Shuter WJ, Schweitzer MJ, Doorenbos H (1984) Rapid deterioration of diabetic retinopathy during treatment with continuous subcutaneous insulin infusion. Diabetes Care 7:236–242
Christiansen A (1973) Radioimmunoelectrophoresis in the determination of insulin binding to IgG. Methodological studies. Horm Metab Res 5:147–154
The DCCT Research Group (1987) Diabetes control and complication trial: results of feasibility study. Diabetes Care 10:1–19
Franetzki M, Wohlers C, Buchholz G. Preclinical evaluation of an implantable pump with stabilized insulin: Technology of the peristaltic pump. Diab Nutr Metab, accepted for publication
Grau U (1985) Chemical stability of insulin in a delivery system environment. Diabetologia 28:458–463
Grau U, Jährling P (1989) Preclinical evaluation of a remote-controlled implantable pump with a compatible insulin preparation. II. Studies on longterm stability of the insulin. Diab Nutr Metab (accepted for publication)
Hepp KD, Renner R, Funcke HJ, Mehnert H, Haerten R, Kresse H (1977) Glucose homeostasis under continous intravenous insulin therapy in diabetics. Horm Metab Res 7 (suppl):72–76
Irsigler K, Kritz H, Hagmüller G (1981) Longterm continous intraperitoneal insulin infusions with an implanted remote-controlled insulin infusion device. Diabetes 30:1072–1075
Kritz H, Hagmüller G, Lovett R, Irsigler K (1983) Implanted constant basal rate insulin infusion devices for type I (insulin-dependent) diabetic patients. Diabetologia 25:78–81
Mecklenburg RS, Benson EA, Benson JW, Blumenstein BA, Fredlund PN, Guinn TS, Metz RJ, Nielsen RL (1985) Long-term metabolic control with insulin pump therapy. N Engl J Med 313:465–8
Morell B, Walter H, Porr O, Sturzenegger J, Froesch ER (1981) Preliminary results in four patients treated during a four month period with a portable intravenous insulin infusion apparatus. In: Irsigler, Kunz, Owens, Regal (eds) New Approaches to Insulin Therapy. MTP Press, Lancaster, pp 41–46
Pickup JC, Keen H, Viberti GC, White MC, Kohner EM, Parson JA, Alberti KGMM (1980) Continous subcutaneous insulin infusion in the treatment of diabetes mellitus. Diabetes Care 3:290–300
Rupp WM, Barbosa JJ, Blackshear JJ, McCarthy HB, Rhode TD, Goldenberg FJ, Rublein TG, Dorman FD, Buchwald H (1982) The use of an implantable insulin pump in the treatment of type II diabetes. N Engl J Med 307:265–270
Schade DS, Eaton RP (1980) The peritoneum — a potential insulin delivery route for a mechanical pancreas. Diabetes Care 3:229–234
Schade DS, Eaton RP, Davis T, Akiya F, Phinney E, Kubica R, Vaugh EA, Day PW (1981) The kinetics of peritoneal insulin absorption. Metabolism 30:149–155
Schade DS, Eaton WS, Edwards WS (1982) A remotely programmable insulin delivery system. Successful short-term implantation in man. JAMA 247:1848–1853
Slama G, Hautecouverture M, Assan R, Tschobroutsky G (1974) One to five days of continuous intravenous insulin infusion in seven diabetic patients. Diabetes 23:732–738
Selam JL, Slingeneyer A, Chaptal PA, Franetzki M, Prestele K, Mirouze J (1982) Total implantation of a remotely controlled insulin minipump in a human insulin-dependent diabetic. Art Organs 6:315–319
Soeldner JS (1981) Treatment of diabetes mellitus by devices. Am J Med 70:183–194 (1981)
Walter H, Kemmler W, Kronski D, Franetzki M, Prestele K, Mehnert H (1982) Treatment of a type I diabetic with the aid of an implanted program — controlled insulin infusion device. Akt Endokr Stoffw 2:48–50
About this article
Cite this article
Walter, H., Günther, A., Kronski, D. et al. Implantation of programmable infusion pumps for insulin delivery in type I diabetic patients. Klin Wochenschr 67, 583–587 (1989). https://doi.org/10.1007/BF01721685
- Insulin infusion pump
- Intravenous, intraperitoneal insulin infusion