Insulin infusion pump systems

When the glueose sensor covered with the MPC polymer membrane, was combined with the insulin infusion pump system, control of the glucose levels using the system was achieved for more than 8 days. Thus, the MPC polymer is useful for prolonging biosensor applications, particularly, implantable sensors. 

In addition to needles and syo inges, alternative techniques for insulin administration have been developed, some availing themselves of the kinetics of insulin insulin pens (supplied preloaded or with replaceable cartridges), external infusions and implantable pumps. These latter are convenient for cm accurately controlled continuously functioning biofeedback system, but pose difficulties for routine replacement in insulin deficiency. Therefore sustained-release (depot) formulations are used to provide an approach reasonably near to natural function and compatible with the convenience of daily living. An even closer approach is provided by the development of (at present inevitably expensive) miniaturised infusion pumps which can be used by reliable patients. 

Drug delivery is covered more adequately, with a variety of MeSH terms including drug delivery systems, drug carriers, and infusion pumps, which has narrower terms such as infusion pumps, implantable, and insulin infusion systems. 

Treatments using insulin analogues or insulin pump treatment with continuous subcutaneous insulin infusion (CSII) have less variability and a lower incidence of hypoglycaemia than seen with traditional insulins and delivery systems. 

The availability of safe, disposable and robust infusion pumps for intravenous fluid and drug delivery could provide a significant improvement in both private and public healthcare. An infusion pump should infuse medical fluids, bloods and nutrients into a patient without failure. Thus, there has been a demand for accurately controllable pump systems, from small capacity units such as insulin infusion to large volume feeding suppliers. Small volume infusion pumps, especially, are designed to be portable for use not only in a hospital but also for special purpose likes charity and battlefield use [23]. 

This medical device is a small, programmable pump that administers insulin via the infusion set, consisting of a cannula and a needle. It is designed to be used for insulin pump therapy (continuous subcutaneous insulin infusion, CSll). The patch pump is a variant that combines the infusion set with the pump in a common housing (usually referred to as the pod). This unit is applied to the skin as an adhesive patch and replaced after two or three days. It is controlled by a separate unit (the personal diabetes manager, PDM) with a wireless link to the pod. Patch pumps were introduced in the USA around 2007 and have been available in Europe since mid-2010. The MID is the electrical chassis for the single-use insulin management system (Fig. 9.7). 

Fig. 7. Systemic (a) human insulin concentration and (b) glucose response following infusion of human insulin from external pump, 5 months postimplantation (Dziubla et ai, 2002).

Programmable implantable medication systems find use in the treatment of diabetes, conditions of chronic pain, and Parkinson s and Alzheimer s diseases. Infusions of morphine can be programmed to deliver the drug when the intensity of pain is high. This reduces the chance of the patient developing tolerance to the opioid. Daily injection of insulin subcutaneously causes pain and sometimes infection in diabetic patients. A delivery system that has high accuracy of pumping... 

Another remotely activated device has been described by Groning et al. (57). They demonstrated in a model the remote control of a device to delivery insulin (Fig. 7). This possibility of external programming and monitoring of insulin pumps is possible for continuous subcutaneous infusion. The use of SMS allows immediate transfer of commands to the pump. There are many pitfalls to overcome the ethics of taking control away from the patients and their carer is but one, and there are safety issues, should the GPS system fad, and presumably if in error the pump is activated by the physician or indeed by individuals accidentally. But there is no doubt that telepharmacy wiU impact on future medicine, whether personalized or not. The personal element could come simply as a result of automated reminders to patients to take their medications also discussed above, but the more sophisticated systems described by Groning et al. wiU also have their place. 

Melberg, S. G., Havelund, S., ViUumsen, J., and Brange, D, 1988, Insulin compatibility with polymer materials used in external pump infusion systems, Diabetic Med. 5 243-247. 

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