Insulin therapy administration devices

Controlled parenteral delivery of proteins has recently been reviewed by Pitt (1950) and Heller (1993a,b). Developments in insulin delivery systems have been reviewed by Saudek (1993), devices for insulin administration by Selam and Charles (1990), and subcutaneous insulin therapy by Houtzagers (1989), Home and Alberti (1992), Koivisto (1993), and Heine (1993). 

Insulin pump therapy consists of a programmable infusion device that allows for basal infusion of insulin 24 hours daily, as well as bolus administration following meals. As seen in Fig. 40-3, an insulin pump consists of a programmable infusion device with an insulin reservoir. This pump is attached to an infusion set with a small needle that is inserted in subcutaneous tissue in the patient s abdomen, thigh, or arm. Most patients prefer insertion in abdominal tissue because this site provides optimal insulin absorption. Patients should avoid insertion sites along belt lines or in other areas where clothing may cause undue irritation. Infusion sets should be changed every 2 to 3 days to reduce the possibility of infection. 

Rare complications are lipoatrophy or hjrpertrophy and insulin edema. Insulin has to be given by injection, with pumps or specific devices for intensive therapy, which all generate specific problems. Other ways of administrating insulin are still experimental. 

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