Continuous intraperitoneal insulin infusion does not increase the risk of organ-specific autoimmune disease in type 1 diabetic patients: results of a multicentric, comparative study

Dufaitre-Patouraux, L.; Riveline, JP; Renard, Éric; Melki, V.; Belicar-Schaepelynck, P; Jl, Selam; Guerci, Bruno; Millot, L.; Brun, J. M.; Fermon, C.; Catargi, Bogdan; Gin, H.; Jeandidier, N.; Lejeune, Pierre-Jean; Lassmann-Vague, V.

doi:10.1016/s1262-3636(07)70300-2

Cited by 6 publications

(6 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, an unusual occurrence of autoimmune hyperthyroidism was suspected, which might suggest that immunogenicity of IP insulin delivery could be not specifically oriented against insulin [105]. Nevertheless, this fear was confirmed neither in a further study on 26 CPII-treated diabetic patients [106] nor in a larger EVAluation dans le Diabéte des lmplants Actifs (EVADIAC) report on 154 patients treated with implantable pumps compared to matched CSII-treated patients [77].…”

Section: Effects Of Cpii On Ia Formationmentioning

confidence: 98%

“…It appeared that only IP delivery was associated with an increase of IAs, suggesting that the route or the delivery mode rather than the insulin was immunogenic [68]. A recent report from the French EVADIAC group found that IA levels were significantly higher in CPII insulin-treated than in CSII-treated patients (32.9% versus 20.2%; p < 0.0001) [77]. Increased IA levels have also been detected by both RIA and enzyme-linked immunosorbent assay (ELISA) methods in a series of 17 type 1 diabetic patients treated by implantable pumps using the IP route and HOE 21PH insulin [7].…”

Section: Effects Of Cpii On Ia Formationmentioning

confidence: 99%

See 1 more Smart Citation

Circulating insulin antibodies: influence of continuous subcutaneous or intraperitoneal insulin infusion, and impact on glucose control

Radermecker

Renard

Scheen

2009

Diabetes Metabolism Res

View full text Add to dashboard Cite

The purification of animal insulin preparations and the use of human recombinant insulin have markedly reduced the incidence, but not completely suppressed, the development of anti-insulin antibodies (IAs). Advances in technologies concerning the mode of delivery of insulin, i.e. continuous subcutaneous insulin infusion (CSII), continuous peritoneal insulin infusion (CPII) and more recently inhaled insulin administration, appear to significantly increase circulating levels of immunoglobulin G (IgG) anti-IAs in diabetic patients. However, the increase is usually moderate and mostly transient as compared to previous observations with poorly purified animal insulin preparations. The clinical impact of these circulating anti-IAs remains unclear. Nevertheless, several studies have suggested that antibodies could retard insulin action, leading to a worsening of postprandial hyperglycaemia and/or serve as a carrier, thus leading to unexpected hypoglycaemia. CPII may be associated with more marked and sustained increase in IAs levels, possibly related to the use of an unstable insulin and the formation of immunogenic aggregates of insulin. The possible clinical consequences of these high levels of IAs remain to be evaluated because a low-glucose morning syndrome or severe insulin resistance with ketone bodies production have been reported in some cases. In conclusion, even if CSII and CPII may promote the development of circulating IAs, this increase does not lead to immunological insulin resistance, compared to that previously described with animal non-purified insulin preparations, and seems to have only marginal influence on blood glucose control or complications in most diabetic patients.

show abstract

Section: Effects Of Cpii On Ia Formationmentioning

confidence: 98%

Section: Effects Of Cpii On Ia Formationmentioning

confidence: 99%

Circulating insulin antibodies: influence of continuous subcutaneous or intraperitoneal insulin infusion, and impact on glucose control

Radermecker

Renard

Scheen

2009

Diabetes Metabolism Res

View full text Add to dashboard Cite

show abstract

“…Although the exact cause remains unknown, it has been suggested that the increased concentrations of anti‐insulin antibodies may be due to insulin modifications occurring during storage in the implantable pump or due to insulin aggregates which are known to be antigenic . The increased anti‐insulin antibodies do not seem to correlate with the presence or absence of other clinical and subclinical autoimmune diseases . Although the anti‐insulin antibodies associate with insulin and have been hypothesized to increase the postprandial blood glucose concentrations and the risk of delayed hypoglycaemia, they do not induce metabolic consequences, changes in insulin requirements or the number of hypoglycaemic episodes …”

Section: Continuous Intraperitoneal Insulin Infusionmentioning

confidence: 99%

Intraperitoneal insulin infusion: treatment option for type 1 diabetes resulting in beneficial endocrine effects beyond glycaemia

Dijk

Logtenberg

Gans

et al. 2014

Clinical Endocrinology

View full text Add to dashboard Cite

SummaryContinuous intraperitoneal insulin infusion (CIPII) is a treatment option for patients with type 1 diabetes mellitus who fail to reach adequate glycaemic control despite intensive subcutaneous (SC) insulin therapy. CIPII has clear advantages over SC insulin administration in terms of pharmacokinetic and pharmacodynamic properties and has been shown to improve glycaemic regulation. Due to the delivery of insulin predominantly in the portal vein, as opposed to systemically, CIPII offers a unique research model to investigate the effects of insulin on endocrine and metabolic parameters in vivo. The aim of the present article is to provide an overview of the literature with respect to the effects of CIPII on glucose management, quality of life, complications and costs, with additional focus on metabolic and endocrine aspects. Finally, future use and research objectives are discussed.

show abstract

“…Compared to multiple subcutaneous injections, direct costs of CIPII were 2.6-fold higher [16]. Another potential drawback might be the increase in antiinsulin antibodies in CIPII patients compared with CSII patients; however, this does not lead to an increase in clinical or sub-clinical autoimmune disease [17].…”

Section: Discussionmentioning

confidence: 99%

Surgical aspects and complications of continuous intraperitoneal insulin infusion with an implantable pump

Haveman

Logtenberg

Kleefstra

et al. 2008

Langenbecks Arch Surg

View full text Add to dashboard Cite

show abstract

Continuous intraperitoneal insulin infusion does not increase the risk of organ-specific autoimmune disease in type 1 diabetic patients: results of a multicentric, comparative study

Cited by 6 publications

References 26 publications

Circulating insulin antibodies: influence of continuous subcutaneous or intraperitoneal insulin infusion, and impact on glucose control

Circulating insulin antibodies: influence of continuous subcutaneous or intraperitoneal insulin infusion, and impact on glucose control

Intraperitoneal insulin infusion: treatment option for type 1 diabetes resulting in beneficial endocrine effects beyond glycaemia

Surgical aspects and complications of continuous intraperitoneal insulin infusion with an implantable pump

Contact Info

Product

Resources

About