Implantable insulin delivery pumps

Abstract

Implantable insulin delivery pumps are a response to the search for an insulin therapy that would be more physiological, more comfortable and, finally, better adapted to instantaneous insulin needs by their connection to a long term glucose sensor. The last decade has been devoted to their technical finalization and to the acquisition of the clinical knowledge on how to use them, so that these devices can be safe and reliable. The forthcoming availability on the market of the specific insulin formulation they require and the present development of glucose sensors are two favourable conditions for the diffusion of this technology aiming at an improved diabetes treatment. This review summarizes the rationale for the choice of intraperitoneal insulin route, the key-steps in assessing their feasibility and effectiveness in blood glucose control of diabetic patients, and the present development of this technique toward an implantable artificial beta-cell.

Clinical Results of an Automated Artificial Pancreas Using Technosphere Inhaled Insulin to Mimic First-Phase Insulin Secretion

“…35,36 In patients with type 1 diabetes using insulin glargine, a randomized trial showed that prandial TI led to significantly lower fasting and 1- and 2-hour postprandial glucose values compared to prandial insulin lispro, with a lower hypoglycemia event rate. 37 Several other published clinical studies have further supported TI’s safety and efficacy as a prandial insulin in type 1 diabetes 29,38,39 and type 2 diabetes. 29,40,41 At the time of the study TI was an investigational drug that was approved on June 27, 2014, as an ultra rapid-acting insulin for oral inhalation indicated for the treatment of adults with type 1 or type 2 diabetes mellitus in the US by the food and drug administration.…”

Intraperitoneal insulin infusion: on the way to the artificial pancreas

“…2) [20,21]. ИП-инфузия инсулина с помощью имплантируе-мой инсулиновой помпы получила в дальнейшем свое развитие, с ее применением проведен ряд успешных клинических исследований [1,22,23]. Сегодня можно встретить только одну модель имплантируемой помпы (MIP 2007C, Medtronic/Minimed, Northridge, CA, США); около 1200 пациентов с СД во всем мире являются поль-зователями этой и более ранних моделей (в основном в странах Европы).…”

Displacement Micropump with Check Valves for Diabetes Care—The Challenge of Pumping Insulin at Negative Pressure

“…The fact that the insulin experiences a negative pressure is a significant difference from other insulin delivery systems, except the implantable pump MIP developed by Minimed to infuse U400 insulin via the intraperitoneal route [22]. The pressure of the MIP reservoir is −275 ± 70 mbar to prevent the risk of overdose induced by leakage and the risk of pocket fill [53][54][55][56]. Most infusion systems are piston pumps that simply push the insulin present into the reservoir to the patient.…”