A preliminary trial of the programmable implantable medication system of insulin delivery

Article Abstract:

Individuals having insulin-dependent diabetes mellitus (IDDM) frequently experience both major and minor complications as a result of abnormal and fluctuating levels of glucose (sugar) in the blood. Frequent intravenous injections of insulin are required on a daily basis to control this condition. A programmable implantable medication system (PIMS) is a device consisting of an insulin pump implanted beneath the skin that continuously delivers insulin in controlled quantities to maintain normal glucose levels; its effectiveness has been studied in animals since the early 1980s. The internal pump appears to have the advantages of convenience and consistency over external pumps or continuous intravenous injections. No long-lasting system has yet been successfully developed for use in humans. A new PIMS was used in a study of 18 patients with IDDM for periods varying from 4 to 25 months. The pump was implanted beneath the skin and the insulin supply was replenished every two months. During the period the pump was in use no incidents of severe hypoglycemia (low blood sugar) or diabetic ketoacidosis (toxicity) were observed. No skin or surgical complications developed. The problems that did occur were the clogging of the catheter by the insulin, a relatively high incidence of mechanical failure by the pump, a short battery life, and skin erosions. The maximum time period for the effective use of the PIMS was found to be two years. Further study is recommended but the PIMS are a promising technique for the even distribution of optimal insulin levels in patients suffering from IDDM.

Research, Evaluation, Drug delivery systems, Insulin pumps

---

A randomized trial of intensive insulin therapy in newly diagnosed insulin-dependent diabetes mellitus

Article Abstract:

Insulin is a hormone secreted by certain cells in the pancreas, beta cells, in response to increased levels of glucose (sugar) in the blood. Insulin-dependent diabetes mellitus (IDDM) is a disease that is thought by some to be due to an abnormality in the immune system that causes the destruction of beta cells, resulting in a lack of insulin. The actual mechanism behind the destruction of beta cells, an autoimmune process, is unknown, but recent research has led to an hypothesis that intensive insulin therapy in the early stages of IDDM might prove helpful in preserving beta cell function. To test this hypothesis, 12 newly-diagnosed adolescents were randomly divided into two groups, one to receive conventional insulin treatment (two standard doses of insulin per day), the other an experimental treatment (two-week hospitalization with maintenance of blood glucose levels by continuous insulin infusion). During the two weeks, the experimental group received four times more insulin than the other group, and this form of external administration of insulin resulted in almost total suppression of their own insulin production. At the end of the two weeks, both groups were treated alike. A year later, those in the experimental group had a measurably greater degree of insulin production, as measured by the levels of C peptide in the blood, and their metabolic processes were more stable. The results indicate that intensive and continuous injection of insulin in the first two weeks after diagnosis of IDDM may improve the patient's own insulin production in the first year.

Analysis, Blood sugar, Blood glucose, C-peptide

---

Addition of biphasic, prandial, or basal insulin to oral therapy in type 2 diabetes

Article Abstract:

An open-label trial for patients with type 2 diabetes randomly assigned to receive biphasic, prandial, or basal insulin while also receiving a maximally tolerated dose of metformin and sulfonylurea is presented. The regimens of biphasic or prandial insulin has greater efficacy than the basal regimen but are observed to be associated with greater risks of hypoglycemia and weight gain.

United States, Comparative analysis, Type 2 diabetes, Clinical report

Similar abstracts:

• Abstracts: The efficacy of an intraosseous injection system of delivering local anesthetic. Counteracting the bitter taste of local anesthetic
• Abstracts: Adrenal insufficiency after operative removal of apparently nonfunctioning adrenal adenomas. Glucocorticoid-Induced Adrenal Insufficiency
• Abstracts: Randomized, controlled trial of clonidine for smoking cessation in a primary care setting
• Abstracts: Cytomegalovirus infection is associated with cardiac allograft rejection and atherosclerosis

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.