IMPLANTABLE INSULIN PUMPS AND METABOLIC CONTROL

The development of implantable, remote-controlled insulin pumps dates back to the early 1970's when it was recognized that conventional insu lin therapy map be inadequate to control microvascular complications. For the first prototypes the intraperitoneal access route was favoured because of a physiological portal/peripheral insulin gradient. With i ntraperitoneal insulin delivery excellent metabolic control can be obt ained with glycohaemoglobin values close to the upper normal range. Al though long-term studies in insulin-dependent diabetic patients show c omparable results with respect to glycaemic control and intermediary s ubstrate levels with intensive conventional therapy, the advantage of intraperitoneal insulin delivery may lie in the low rate of hypoglycae mic episodes.