Insulin pump systems

Allergic reactions to insulin include erythema, pruritus, and indurations,22 which usually are transient. For the more troublesome reactions, treatment options include dexamethasone, desensitization, or change in delivery system (i.e., insulin pump or inhaled insulin). 

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. 

Groning R, Remmerbach S, Jansen AC. Telemedicine insulin pump controlled by the Global System for Mobile Communications (GSM). Int J Pharm 2007 339 61-65. 

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. 

The above examples have only scratch the surface of the expanding role of the pack. What about dermal patches, implants, insulin pens, pump systems, suppository and pessary delivery systems, nebulisation, puffer packs, Ocuserts , a review of unit dose applications, etc. Systems are now so numerous that doing a paper search and review would take several weeks. However, they do indicate the new roles which are being undertaken by the pack. Each new system challenges new sets of tests in order to evaluate performance and efficiency. 

Unlike the bedside or portable insulin delivery systems for which commercially available peristaltic or syringe pumps may be used, the key component of an implantable (open-loop) artificial pancreas is the specially developed miniature insulin pump. 

Another method of insulin delivery is the insulin pump, which is intended for a select group of individuals, such as tlie pi iant woman with diabetes witli early long-tenn complications and those witli, or candidates for, renal transplantation. This system attempts to mimic tlie body s nonnal pancreatic function, uses only r ilar insulin, is battery powered, and requires insertion of a needle into SC tissua The needle is changed every 1 to 3 days. The amount of insulin injected can be adjusted according to blood glucose monitoring, which is usually done four to eight times per day. 

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. 

In a somewhat different approach to a self-regulating insulin delivery system, Siegel and co-workers (Siegel era/., 1988 Siegel and Firestone, 1990) are investigating the feasibility of a mechanochemical pump. The fimction-... 

Examples of analogous complete systems in chemistry are still rare. The best example is perhaps the artificial pancreas, in which a glucose sensor measures the actual blood-glucose concentrations in order to control an appropriate actuator, the insulin pump. Bedside devices for this purpose... 

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]. 

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