Multicentre Trial of a Programmable Implantable Insulin Pump in Type I Diabetes

Programmable implantable pumps permitting variable-rate intraperitoneal insulin infusion are currently investigated as a potential alternative to subcutaneous insulin therapy. An improved version of the Siemens implantable system has been evaluated in 6 European centres on 31 type I diabetic patients treated for 10–30 months. Contrary to other pump models there were no proven pump malfunctions and only one no-flow reduction unrelated to catheter obstruction. The latter resulted in 12 surgical catheter replacements. There were 2.0 incidents of programmer malfunctions per patient-year easily managed by reconfiguration or replacement. Insulin remained clear and active in the pump reservoir and glycaemic control remained in the near-normoglycaemic range. Thus, insulin therapy with the Siemens implantable pump is feasible and effective up to 2.5 years.