IMPLANTABLE INSULIN PUMP - FIRST STEP TOW ARDS AN ARTIFICIAL PANCREAS

Recent improvements in miniaturisation of implantable pumps and the ab ility of their control by teletransmission allow implantation of auton omous pumps which administer insulin into the peritoneal cavity. Fifty -six patients with diabetes mellitus underwent implantation of 66 pump s with a mean function life of 21.8 months per patient. No patient has died to date. Tolerance of implanted components was good. Morbidity w as limited to local events, in this series 4 cutaneous erosions, two o f them leading to final pump explantation. Mean global blood-sugar, pr e- and post-prandial blood-sugar, and glycosylated hemoglobin assays w ere all lower versus pre-implantation assays. A statistically signific ant difference was demonstrated regarding mean global blood-sugar. The frequency of severe hypoglycemia incidents (2 in our series) and bioc himical hypoglycemia (blood-sugar < 65 mg/100 ml) was decreased, repre senting a major benefit of the technique. The patients wellbeing and q uality of life were notably improved. Implantable insulin-pump may be offered as alternative treatment to conventional insulin-therapy, espe cially in cases of diabetes which are difficult to control and particu larly in cases with frequent hypoglycemic malaise.