The Programmable Implantable Medication System (PIMS): Design Features and Pre-Clinical Trials

Saudek, C. D.; Fischell, Robert E.; Swindle, M. Michael

doi:10.1055/s-2007-1004885

Cited by 13 publications

(4 citation statements)

References 11 publications

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“…These limitations include the visibility of the pump, the risk attendant to the break in the skin barrier created by the needle or catheter, and the systemic delivery of insulin with the subcutaneous device. These issues have provided the impetus to develop the implantable insulin pump (IIP)1, 66–68.…”

Section: The Implantable Insulin Pumpmentioning

confidence: 99%

Insulin pump therapy in Type 1 pediatric patients: now and into the year 2000

Kaufman

Halvorson

Miller

et al. 1999

Diabetes Metab. Res. Rev.

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There are a number of medical conditions such as growth failure in children, pregnancy, lipid abnormalities, and early complications that are improved by the meticulous glycemic control that can be achieved with insulin pump therapy (CSII). By using an insulin pump, many patients with severe hypoglycemia, the dawn phenomenon, extremes of glycemic excursion, recurrent diabetic ketoacidosis (DKA) and hypoglycemia unawareness have amelioration of these problems. However, pump therapy involves problems such as weight gain, recurrent ketosis due to pump failure, infections, and risk of hypoglycemia. Owing to many developmental issues, young children may not be able to wear the pump without parental supervision. We have used the pump at night time only in these patients. This has allowed children of 7–10 years of age to benefit from improved nocturnal glycemia without the risk of pump therapy when they are without an adult to help. We have also used the pump in subjects with recurrent DKA and in our general patient population (mean age 13.6±3.9 years). In our pump cohort, CSII led to improvement in quality of life, knowledge, adherence, and responsibility. A reduction in hypoglycemia, DKA rate and mean HbA1c was associated with pump usage. For this to occur, however, pump education must be geared to the pediatric subject and his/her family. Education materials and tools help in learning how to use the pump and how to deal with the intricacies of basal and bolus dosing, and the effect of exercise, food and illness on diabetes management. The pump has improved since it was first introduced and these modifications have made it easier, more painless and less hazardous. With the development of continuous glucose sensors and implantable pumps, the next century will see pump therapy lead to the artificial pancreas. Copyright © 1999 John Wiley & Sons, Ltd.

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Section: The Implantable Insulin Pumpmentioning

confidence: 99%

Insulin pump therapy in Type 1 pediatric patients: now and into the year 2000

Kaufman

Halvorson

Miller

et al. 1999

Diabetes Metab. Res. Rev.

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“…In a small group of 20 diabetic patients treated with continuous subcutaneous insulin infusion, 25% developed new-onset insulin allergy that had not been present before pump therapy (22). Continued use of subcutaneous insulin-infusion pumps and newer investiga- tions with implantable systems raise the important issue of stability of insulin within a delivery system (23). Unique factors involved in the use of either implantable or external pumps include prolonged contact with plastic reservoirs and tubing, higher-temperature exposure, agitation as a result of a constant pumping motion, and higher insulin concentrations (24).…”

Section: Discussionmentioning

confidence: 99%

Persistent Cutaneous Insulin Allergy Resulting From High-Molecular-Weight Insulin Aggregates

1990

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Cutaneous insulin allergy remains a clinical problem despite the use of highly purified human insulins. We used in vitro lymphocyte-transformation studies to examine the reactivity of various insulin formulations in diabetic patients with (n = 4) and without (n = 8) cutaneous allergies. Nonspecific response to concanavalin A demonstrated a greater than 40-fold response in both groups. Control patients did not respond to the addition of commercial insulin preparations (stimulation index [SI] less than 4), whereas allergic patients had an 11-fold response to beef (P less than 0.01), a 10-fold response to pork (P less than 0.01), and a 6-fold response to human (P less than 0.01) insulins. This response was limited to a single insulin manufacturer's preparations and was uniform in all three species tested. Efforts to identify the offending agent revealed no lymphoblast transformation when crystalline insulin was used or when commercial preparations were purified to a single peak by high-performance liquid chromatography (HPLC). Pure crystalline insulin dimers of beef, pork, and human species were tested; control subjects responded with mean SIs of 1.9, 1.9, and 1.8, respectively, whereas allergic patients showed greater reactivity to beef (SI 7.3) and pork (SI 14.8). The lymphoblast-transformation response to crystalline human dimer was dose dependent with mean SIs of 0.9 at low concentration (2.8 ng/ml) and 19.2 at a higher concentration (20.4 ng/ml). The commercial insulin preparations were run on size-exclusion HPLC to determine high-molecular-weight aggregate content. Independent of species, a single manufacturer had products demonstrating aggregate levels 3- to 6-fold higher than those found in other manufacturers' preparations.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…Given the pharmacokinetic benefits that the implantable DDSs work directly at the target site, these miniaturized devices implanted deep in the body are limited by their inaccessibility for drug refills. So far, other than the refill of the subcutaneous implant with a syringe, [ 65 ] only individually encapsulated drug reservoirs have been demonstrated in microchips. [ 66 ] Flexible substrates and the miniaturized size of the devices pose an even bigger challenge to the refill and encapsulation techniques.…”

Section: Categories Of Bioelectronic Ddssmentioning

confidence: 99%

Recent Advances in Bioelectronics for Localized Drug Delivery

Jiang,

Wu,

Xiao

et al. 2023

Small Methods

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The last decade has witnessed remarkable advancements in bioelectronics, ushering in a new era of wearable and implantable devices for drug delivery. By utilizing miniaturized system design and/or flexible materials, bioelectronics illustrates ideal integration with target organs and tissues, making them ideal platforms for localized drug delivery. Furthermore, the development of electrically assisted drug delivery systems has enhanced the efficiency and safety of therapeutic administration, particularly for the macromolecules that encounter additional challenges in penetrating biological barriers. In this review, a concise overview of recent progress in bioelectronic devices for in vivo localized drug delivery, with highlights on the latest trends in device design, working principles, and their corresponding functionalities, is provided. The reported systems based on their targeted delivery locations as wearable systems, ingestible systems, and implantable systems are categorized. Each category is introduced in detail by highlighting the special requirements for devices and the corresponding solutions. The remaining challenges in this field and future directions are also discussed.

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The Programmable Implantable Medication System (PIMS): Design Features and Pre-Clinical Trials

Cited by 13 publications

References 11 publications

Insulin pump therapy in Type 1 pediatric patients: now and into the year 2000

Insulin pump therapy in Type 1 pediatric patients: now and into the year 2000

Persistent Cutaneous Insulin Allergy Resulting From High-Molecular-Weight Insulin Aggregates

Recent Advances in Bioelectronics for Localized Drug Delivery

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