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Implantable insulin pumps. A position statement about their clinical use
E Renard1, P Schaepelynck-Bélicar,
1Service des maladies endocriniennes, hôpital Lapeyronie, 34295 Montpellier cedex 05, France. e-renard@chu-montpellier.fr
Diabetes & Metabolism
|February 16, 2007
Summary
Implantable insulin pumps improve blood glucose stability and reduce severe hypoglycemia in diabetic patients. They offer metabolic benefits for type 1 diabetes patients struggling with glycemic control.
Area of Science:
- Endocrinology
- Medical Devices
- Diabetes Management
Background:
- Implantable insulin pumps offer a continuous subcutaneous insulin infusion (CSII) alternative.
- Assessing their long-term safety, efficacy, and specific indications is crucial for clinical practice.
Purpose of the Study:
- To review the clinical use of implantable insulin pumps.
- To define evidence-based indications for this advanced diabetes therapy.
Main Methods:
- A comprehensive review of published literature over 15 years.
- Analysis of the EVADIAC group's centralized database of implantable pump usage.
Main Results:
- Implantable pumps improve blood glucose stability and reduce severe hypoglycemia.
- Randomized trials show reduced glycemic fluctuations and improved quality of life compared to subcutaneous therapy.
- Weight loss observed in type 2 diabetes patients; insulin aggregation remains a reversible issue.
Conclusions:
- Implantable insulin pumps are safe and effective for type 1 diabetes patients with suboptimal glycemic control.
- Indications include persistent hyperglycemia (HbA1c >7%) and significant glycemic variability or severe hypoglycemia despite optimal subcutaneous treatment.
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