Implantable insulin delivery pumps

Characterization of Cyclic Olefin Copolymers for Insulin Reservoir in an Artificial Pancreas

Type-1 diabetes is one of the most prevalent metabolic disorders worldwide. It results in a significant lack of insulin production by the pancreas and the ensuing hyperglycemia, which needs to be regulated through a tailored administration of insulin throughout the day. Recent studies have shown great advancements in developing an implantable artificial pancreas. However, some improvements are still required, including the optimal biomaterials and technologies to produce the implantable insulin reservoir. Here, we discuss the employment of two types of cyclic olefin copolymers (Topas 5013L-10 and Topas 8007S-04) for an insulin reservoir fabrication. After a preliminary thermomechanical analysis, Topas 8007S-04 was selected as the best material to fabricate a 3D-printed insulin reservoir due to its higher strength and lower glass transition temperature (Tg). Fiber deposition modeling was used to manufacture a reservoir-like structure, which was employed to assess the ability of the material to prevent insulin aggregation. Although the surface texture presents a localized roughness, the ultraviolet analysis did not detect any significant insulin aggregation over a timeframe of 14 days. These interesting results make Topas 8007S-04 cyclic olefin copolymer a potential candidate biomaterial for fabricating structural components in an implantable artificial pancreas.

Toward Dosing Precision and Insulin Stability in an Artificial Pancreas System

A fully implantable artificial pancreas (AP) still represents the holy grail for diabetes treatment. The quest for efficient miniaturized implantable insulin pumps, able to accurately regulate the blood glucose profile and to keep insulin stability, is still persistent. This work describes the design and testing of a microinjection system connected to a variable volume insulin reservoir devised to favor insulin stability during storage. The design, the constitutive materials, and the related fabrication techniques were selected to favor insulin stability by avoiding—or at least limiting—hormone aggregation. We compared substrates made of nylon 6 and Teflon, provided with different surface roughness values due to the employed fabrication procedures (i.e., standard machining and spray deposition). Insulin stability was tested in a worst case condition for 14 days, and pumping system reliability and repeatability in dosing were tested over an entire reservoir emptying cycle. We found that nylon 6 guarantees a higher insulin stability than Teflon and that independent of the material used, larger roughness determines a higher amount of insulin aggregates. A dedicated rotary pump featured by a 1-μL delivery resolution was developed and connected through a proper gear mechanism to a variable volume air-tight insulin reservoir. The microinjection system was also able to operate in a reverse mode to enable the refilling of the implanted reservoir. The developed system represents a fundamental building block toward the development of a fully implantable AP and could be advantageously integrated even in different implantable drug delivery apparatus (e.g., for pain management).

Clinical results of an automated artificial pancreas using technosphere inhaled insulin to mimic first-phase insulin secretion

OBJECTIVE

The purpose of this study was to investigate whether or not adding a fixed preprandial dose of inhaled insulin to a fully automated closed loop artificial pancreas would improve the postprandial glucose control without adding an increased risk of hypoglycemia.

RESEARCH DESIGN AND METHODS

Nine subjects with T1DM were recruited for the study. The patients were on closed-loop control for 24 hours starting around 4:30 pm. Mixed meals (~50 g CHO) were given at 6:30 pm and 7:00 am the following day. For the treatment group each meal was preceded by the inhalation of one 10 U dose of Technosphere Insulin (TI). Subcutaneous insulin delivery was controlled by a zone model predictive control algorithm (zone-MPC). At 11:00 am, the patient exercised for 30 ± 5 minutes at 50% of predicted heart rate reserve.

RESULTS

The use of TI resulted in increasing the median percentage time in range (70-180 mg/dl, BG) during the 5-hour postprandial period by 21.6% (81.6% and 60% in the with/without TI cases, respectively, P = .06) and reducing the median postprandial glucose peak by 33 mg/dl (172 mg/dl and 205 mg/dl in the with and without TI cases, respectively, P = .004). The median percentage time in range 80-140 mg/dl during the entire study period was 67.5% as compared to percentage time in range without the use of TI of 55.2% (P = .03).

CONCLUSIONS

Adding preprandial TI (See video supplement) to an automated closed-loop AP system resulted in superior postprandial control as demonstrated by lower postprandial glucose exposure without addition hypoglycemia.

Microsystems in medicine – results of an international survey

The utilization of microsystems technology (MST) in medical applications is instrumental in opening up new market segments, in the creation of novel, more effective diagnosis and therapy options in medicine, as well as in the further development of MST. However, the players in the healthcare industry are faced with technical and non-technical difficulties. The present study analyzes this emerging field from the viewpoint of medicine, market, and MST. It identifies applications of medical devices with microsystems components and analyzes their potentials in great detail. Thus, especially the creation of new market segments is expected from a broad use of MST in medicine. Furthermore, problems and conditions during the entry of microsystems into medical products are illuminated, in particular considering the specific market features of the healthcare industry. The high expenditure necessary for establishing this technology in healthcare industry is the most significant obstacle, since this market is dominated by small and medium-sized enterprises (SMEs). But there are non-technical difficulties as well. This article presents selected results of the study, which was carried out in the scope of the EU project netMED (virtual institute on micromechatronics for biomedical industry).

Microtechnologies in medicine: an overview

Microsystems technology (MST) has become a significant enabler of novel medical devices and implants over the last years. Typical examples are MST units in cardiac rhythm management devices or in hearing implants. A classification of medical MST applications can be made according to their relationship with the anatomy that is based on the kind and duration of interaction with the human body: Class 1: Extra-corporeal devices such as telemetric health monitoring systems or point of care testing systems. Class 2: Intra-corporeal devices such as intelligent surgical instruments. Class 3: Temporarily incorporated or ingested devices, such as telemetric endoscopes. Class 4: Long-term implantable devices such as telemetric implants. Medical applications of MST are growing at double-digit compounded growth rates, leading to a forecasted global market volume of over USD 1 billion in 2006 or 2007, making MST devices a relevant segment of the medical technology market. The clinical foundation for promoting the use of MST in medicine is mainly based on the significant potential of MST to enable products that improve early disease detection and the monitoring of chronic illnesses. This refers to a number of the most important health problems such as cardiovascular disease, hypertension, diabetes and cancer, to name just a few. More recently microrobotics has become a relevant research area for enabling the atraumatic transport of MST-enhanced diagnostic and therapeutic devices inside the human body.