Clinical experience with an implanted closed-loop insulin delivery system.
OBJECTIVE
To report the first clinical experience with a prototype of implanted artificial beta-cell.


METHODS
The Long-Term Sensor System project assessed the feasibility of glucose control by the combined implantation of a pump for peritoneal insulin delivery and a central intravenous glucose sensor, connected physically by a subcutaneous lead and functionally by PID algorithms. It was performed in 10 type 1 diabetic patients from 2000 to 2007.


RESULTS
No harmful complication related to implants occurred. Insulin delivery was affected by iterative but reversible pump slowdowns due to insulin precipitation. Glucose measurement by the intravenous sensors correlated well with meter values (r = 0.83-0.93, with a mean absolute deviation of 16.5%) for an average duration of 9 months. Uploading of pump electronics by PID algorithms designed for closed-loop insulin delivery allowed in-patient 48 hourtrials.


CONCLUSIONS
Although the concept of a fully implantable artificial beta-cell has been shown as feasible, improvements in the sensor structure to increase its longevity and decrease sensor delay that affected closed-loop control at meal-times are expected.
Renard
Eric
E
Endocrinology Department, Lapeyronie Hospital, Montpellier, France. e-renard@chu-montpellier
D015374:Biosensing Techniques / Q000379:methods*; D001786:Blood Glucose / Q000032:analysis*; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D005240:Feasibility Studies; D006801:Humans; D015918:Infusion Pumps, Implantable; D007263:Infusions, Parenteral / Q000379:methods; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D007332:Insulin Infusion Systems; D008991:Monitoring, Physiologic / Q000379:methods; D019397:Pancreas, Artificial
D001786:Blood Glucose; D007328:Insulin