An implantable insulin delivery system has several advantages not shared by currently available, portable external delivery devices. First, since the implantable system does not come in contact with the external environment, insulin delivery routes other than the subcutaneous tissue may be utilized without the danger of infection. These alternative routes may provide more rapid insulin absorption, enhanced hepatic insulinization, and improved diabetic control for “C”-peptide-negative brittle diabetic patients. Second, the implantable system is protected from external trauma, permitting a wider range of daily activities and sporting events. Third, the implantable system is easily concealed by clothing, thereby increasing patient acceptance of it. However, an implantable system also has disadvantages. First, surgery will be required to implant or explant the pump module and reservoir, and second, the implanted system must be highly reliable and include failsafe mechanisms to insure the safety of the recipient. These advantages and disadvantages have resulted in delineation of general specifications for an inv plantable insulin delivery system. Desirable features of an implantable insulin delivery system include (1) reliability and failsafe operation, (2) being implantable and explantable under local anesthesia, (3) long battery life, (4) multiple insulin delivery rates, (5) small size and weight, (6) biocompatible materials, (7) remote programmability based upon recipient blood glucose monitoring, and (8) ability to deliver concentrated insulin with infrequent reservoir refilling. Using available technology, each of these specifications has been incorporated into the functioning of our current implant system, which is being tested in diabetic dogs. Future experiments in man will undoubtedly alter and add to the current specifications.
[1]
A. Albisser,et al.
Insulin aggregation in artificial delivery systems
,
1980,
Diabetologia.
[2]
A NEW LOW-POWER HIGH-RELIABILITY INFUSION PUMP
,
1979
.
[3]
T. Castberg.
Complications from the pacemaker pocket. Prophylaxis, treatment and results.
,
2009,
Acta medica Scandinavica. Supplementum.
[4]
R. H. Rigdon.
Tissue reaction to foreign materials.
,
1975,
CRC critical reviews in toxicology.
[5]
O. Sugar,et al.
Subcutaneous reaction to silicone in ventriculoperitoneal shunts. Long-term results.
,
1974,
Journal of neurosurgery.
[6]
R. Revie,et al.
Comparison of the in vivo and in vitro corrosion of 18-8 stainless steel and titanium.
,
1969,
Journal of biomedical materials research.
[7]
R. Ames.
Ventriculo-peritoneal shunts in the management of hydrocephalus.
,
1967,
Journal of neurosurgery.
[8]
J. Autian,et al.
TOXICITY, UNTOWARD REACTIONS, AND RELATED CONSIDERATIONS IN THE MEDICAL USE OF PLASTICS.
,
1964,
Journal of pharmaceutical sciences.
[9]
S. Dimant.
SILICONE RUBBER IN SURGERY
,
1954
.