External and implantable insulin pumps: current place in the treatment of diabetes | JoVE Visualize

External and implantable insulin pumps: current place in the treatment of diabetes

¹Department of Diabetology, Hotel-Dieu Hospital, 1, Place du Parvis Notre-Dame, F-75181 Paris, France.

Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [And] German Diabetes Association|July 20, 2001

View abstract on PubMed

Summary

Continuous subcutaneous insulin infusion (CSII) pumps offer advantages over multiple daily injections (MDI) for diabetes management. Implantable insulin pumps show better metabolic control but are costly and limited in availability.

Area of Science:

Endocrinology
Medical Devices
Diabetes Technology

Background:

External insulin infusion (CSII) pumps are gaining traction, with nearly 100,000 users in the USA.
The market is dominated by two manufacturers and two insulin types.
CSII offers benefits over multiple subcutaneous injections (MDI), including reduced nocturnal hypoglycemia and increased flexibility.

Purpose of the Study:

To review the current status and future prospects of external and implantable insulin pumps.
To compare the efficacy and safety of CSII and implantable pumps.
To identify optimal patient indications for each pump type.

Main Methods:

Review of current literature and market analysis of insulin pump technologies.
Comparison of metabolic outcomes and adverse events between CSII and implantable pumps.
Analysis of cost-effectiveness and reimbursement trends.

Main Results:

CSII pumps are indicated for patients with poor MDI control or recurrent hypoglycemia.
Implantable insulin pumps, though not widely commercialized, demonstrate superior glycemic control and reduced hypoglycemia compared to CSII.
Catheter obstruction is the primary adverse event for implantable pumps (15% per patient-year).

Conclusions:

CSII pumps are a valuable tool for improving diabetes management, particularly for specific patient groups.
Implantable insulin pumps offer enhanced metabolic benefits but are limited by high cost and restricted availability.
Future research and development are needed to expand access and reduce costs for advanced insulin pump therapies.