Implanted Pump

[karen]

DOME: Diabetes' Rising Tide (http://www.hopkinsmedicine.org/dome/0211/news_report1.cfm)

[nneighbour]

This article is from 2002. Has anything come of this or has it just been another case of speaking too soon?

[JediSkipdogg]

MM actually has an implanted pump in Europe. I think it's for study patients only, but supposedly it's very successful. Of course, I'm not sure of the actual pump failure rate if there is one (think about it, if it fails, surgery is the only way to fix it and that doesn't happen overnight after a failure.)

[owlyn]

This has been under development since at least the early 1980s. I am aware of a very similar device that was tried at Thomas Jefferson University Hospital in Philadelphia around that time. This is not new at all. The same issues were cited then.

[HelenM]

There are about 400 people with 'pompes intra-péritonéales ' in France. There is quite a detailed description and evaluation at http://www.has-sante.fr/portail/upload/docs/application/pdf/cepp-1216.pdf but you need to be able to read French.
There has been a long term study since 1995 of implanted pumps and a series of trials in the US. The health ministry has recently decided that these pumps are to be available (ie paid for) for a some patients who are not well controlled or who have serious hypos. (they suggest there will be about 50-70 patients a year)
I'm not sure of the actual pump failure rate
If I read it correctly.(??)
Since 1995 there have been 1954.6 patients a year (in France).
There were 38 serious problems.
8 prematurely discharged batteries
4 cases where it was impossible to empty or fill the the reservoir
1 case of BS rising 2 days after implantation
4 problems with the remote control
1 split(?) catheter
.
In another study (with a different model) of 40 patients,13 had no problems, 24 had under delivery of insuline and three had to have the implant removed, 2 because of infection 1 because of electronic failure.
In the American studies, in one group 17% had serious problems, in an other 13.5%.
They also mention cases in the trials of infection and some of the patient becoming allergic to the insulin.

[JediSkipdogg]

Thanks Helen. Those failure rates are way to high for my blood. Especially since you can't just disconnect or shut it off when it fails. YOu either have to hope it completely fails and doesn't start working again or hope you can get to the OR to have it removed ASAP.

[nneighbour]

Would it be possible for the doctor to miss the reservoir and inject 3 months worth or insulin into the patient's body instead? Or for the reservoir to leak, again causing a HUGE amount of insulin to be released into the patient's body? Worst case scenario type over here.

[Cyborg]

Never say never :bandit:

[HelenM]

Those failure rates are way to high for my blood.
Actually re reading in day time(not at 1am as last night) I think the rates are worse than I suggested. At the moment there are 348 patients active in the French study and there have been 1954.6 patient years studied (not patients)

As for clinical results they don't seem to be that good at reducing HBA1c though there were less hypos but perhaps they would have been achieved with any intervention and education. I really don't think that it will normally be clinically justified. A subscription to a forum like this would be more cost effective.I realy think that the purpose of these studies is to get one part of an eventual closed system working well.

[BriOnH]

in 1995 I met a guy, who lives in america, that had an implanted pump. I met him at camp. He had a remote control which he used to control it. When he pressed on his stomach you could see the outline of it - it looked like a miniature flying saucer was implanted in his stomach. I'll try to find out what happened with him. I know he said the battery had to be replaced every 5 years.

From article:

One hundred years ago, physicians didn't understand much about diabetes. Even the foremost clinician of the day, Hopkins' own William Osler, used to tell his students that there was really only one thing that could limit the progress of diabetes: opium.

Learn something new everyday.