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A remotely programmable insulin delivery system. Successful short-term implantation in man
JAMA
|April 2, 1982
Summary
A remotely controlled insulin pump was successfully implanted in a type I diabetic patient, demonstrating feasibility for improved glucose control. This programmable system normalized blood glucose and insulin levels, offering a potential new treatment option.
Area of Science:
- Biomedical Engineering
- Endocrinology
- Surgical Innovation
Background:
- Type I diabetes mellitus requires continuous insulin management.
- Existing insulin delivery methods have limitations.
- Implantable, programmable insulin delivery systems offer potential for enhanced glycemic control.
Purpose of the Study:
- To evaluate the feasibility of a remotely controlled, programmable insulin delivery system in a human patient with type I diabetes.
- To address surgical and technical challenges associated with implantable insulin pump systems.
- To assess the efficacy of the implanted system in normalizing glucose and insulin profiles.
Main Methods:
- Submuscular implantation of an insulin pump with a subcutaneous reservoir and peritoneal catheter.
- Post-implantation assessment using dye contrast roentgenography, vasopressin stimulation, and reservoir volume monitoring.
- One-month trial of short-acting insulin delivery via the implanted system.
Main Results:
- Successful surgical implantation with no postoperative complications and rapid wound healing.
- Demonstrated ability to refill the reservoir percutaneously.
- Achieved normalization of mean plasma glucose and glycosylated hemoglobin levels.
- Normalized plasma insulin profiles with mealtime peaks.
Conclusions:
- Implantation of a remotely programmable insulin pump is feasible in patients with type I diabetes.
- The system effectively controlled glucose and insulin levels.
- Further research is needed to identify patient subgroups who would benefit most from this technology.