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Related Experiment Videos

Long-term intraperitoneal insulin delivery.

H A Pitt1, C D Saudek, H A Zacur

  • 1Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland.

Annals of Surgery
|October 1, 1992
PubMed
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Implanted insulin pumps offer a safe and effective treatment for insulin-dependent diabetes mellitus (IDDM). This study shows improved glucose control and excellent patient acceptance with long-term intraperitoneal insulin delivery.

Area of Science:

  • Endocrinology
  • Medical Devices
  • Diabetes Management

Background:

  • Insulin-dependent diabetes mellitus (IDDM) requires lifelong management.
  • Traditional insulin delivery methods have limitations.
  • Implantable insulin pumps offer a potential alternative for improved glycemic control.

Purpose of the Study:

  • To evaluate the long-term safety and efficacy of remotely controlled implanted insulin pumps for IDDM management.
  • To assess patient outcomes, including survival, glucose control, and quality of life.
  • To identify and address challenges associated with intraperitoneal insulin delivery.

Main Methods:

  • Retrospective analysis of 21 patients with IDDM managed with implanted insulin pumps over 5 years.
  • Intraperitoneal delivery of U-400 insulin with a surfactant.

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  • Monitoring of patient survival, glycemic control, system survival, and complications.
  • Evaluation of quality of life and patient acceptance.

    • Main Results:

    • All 21 patients survived, with a mean follow-up of 39.3 months.
    • 90% 5-year actuarial system survival for intraperitoneal insulin delivery.
    • Improved glucose control observed, particularly in the first 16 months, without increased severe hypoglycemia.
    • Catheter blockage occurred in 43% of patients but was successfully managed via laparoscopic repair or catheter change.
    • Pre-existing nephropathy, neuropathy, and retinopathy remained stable.
    • Excellent quality of life and patient acceptance reported.

    Conclusions:

    • Long-term intraperitoneal insulin delivery via implanted pumps is a safe and effective treatment for type 1 diabetes.
    • Aggressive management of catheter blockage is crucial for sustained therapeutic success.
    • Implantable insulin pump therapy demonstrates significant benefits in glycemic control and patient well-being.