[Insulin administration systems. Possibilities and difficulties].
Conventional insulin therapy, particularly when intensive, dose not provide all the comfort and effectiveness desired. The new insulin therapy methods that are, or will soon be, available are described in this review paper. The new types of subcutaneous insulin administration include the so-called "fountain-pens"--in fact ready-to-use syringes--and portable insulin pumps, which are helpful to some patients. Pancreas and islets transplantations are limited by the problem of tissue harvesting and by the necessity of chronic immunosuppression. Nasal insulin sprays will replace rapid insulin injections when the problem of bioavailability is solved and the lack of toxicity is demonstrated. The implantable artificial pancreas is still awaiting the development of long-term reliable glucose sensors, but one of its elements, the implantable insulin pump, is already operational; its safety and reliability have now been proven; its effectiveness seems to result from a better stabilization of blood glucose level variations; it will not supersede conventional injections, but it is the only alternative for patients with poor glycaemia control and notably for those at high risk of hypoglycaemia.
Selam
J L
JL
Service de Diabétologie, Hôtel-Dieu, Paris.
Slama
G
G
D000280:Administration, Inhalation; D006801:Humans; D015918:Infusion Pumps, Implantable; D007279:Injections, Subcutaneous; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems; D016381:Islets of Langerhans Transplantation; D016035:Pancreas Transplantation / Q000379:methods
D007328:Insulin
Systèmes d'administration d'insuline. Possibilités et difficultés.