French multicentre experience of implantable insulin pumps

Abstract

Limitations of intensive diabetes treatment with subcutaneous insulin include achievement of only near-normoglycaemia and increased risk of hypoglycaemia. Programmable implantable pumps permit variable rates of intraperitoneal insulin infusion. The French experience represents 224 type I adult diabetic patients followed up for 353 patient-years in seven centres. Compared with pre-implantation values with intensive subcutaneous insulin, glycaemic control was significantly improved with implantable pumps: glycosylated haemoglobin fell from 7·4 (1·8)% to 6·8 (1·0)% at 6 months (mean, SD, p<0·001). The incidence of severe episodes of hypoglycaemia decreased from 15·2 to 2·5 per 100 patient-years (p<0·001). Intraperitoneal insulin delivery with implantable pumps improved the risk-benefit ratio of intensive insulin.