title: A recent survey confirms the efficacy and the safety of implanted insulin pumps during long-term use in poorly controlled type 1 diabetes patients.
abstract: BACKGROUND
  This article reports a prolonged trial with insulin pumps implanted in patients with type 1 diabetes showing poor glucose control and a high rate of complications.
  
  
  METHODS
  We reviewed data from 181 patients undergoing implanted insulin pump therapy. Analysis included hemoglobin A1c (HbA1c) values, body weight, and diabetes complications status.
  
  
  RESULTS
  At implantation, the mean age was 43 (range, 19-72) years, mean duration of diabetes was 22.2 (2-52) years, and mean body weight was 68.6 (43-104) kg. The complication status involved retinopathy (62% of patients), neuropathy (34.6%), nephropathy (26%), and cardiovascular disease (14%). Patients' previous insulin treatment regimen was multiple daily injections (17.1%) or continuous subcutaneous insulin infusion (82.9%). HbA1c levels significantly dropped from 7.9 ± 1.2% to 7.6 ± 1.2% after 1 year (P < 0.01) and remained within the range of 7.5-7.6% for up to 5 years. No significant variation of body weight or complications status occurred.
  
  
  CONCLUSIONS
  Implanted insulin pump therapy demonstrates long-term benefits in type 1 diabetes patients who have poor prognosis under intensive subcutaneous treatment.
authors.affiliation: CHU-Hôpitaux Sud, 270 boulevard de Sainte Marguerite, 13009 Marseille, France. pauline.schaepelynck@ap-hm.fr
authors.forename: Pauline
authors.initials: P
authors.lastname: Schaepelynck
authors.forename: Eric
authors.initials: E
authors.lastname: Renard
authors.forename: Nathalie
authors.initials: N
authors.lastname: Jeandidier
authors.forename: Hélène
authors.initials: H
authors.lastname: Hanaire
authors.forename: Catherine
authors.initials: C
authors.lastname: Fermon
authors.forename: Sabine
authors.initials: S
authors.lastname: Rudoni
authors.forename: Bogdan
authors.initials: B
authors.lastname: Catargi
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Riveline
authors.forename: Bruno
authors.initials: B
authors.lastname: Guerci
authors.forename: Luc
authors.initials: L
authors.lastname: Millot
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Martin
authors.forename: Agnès
authors.initials: A
authors.lastname: Sola
mesh_terms: D000328:Adult; D000368:Aged; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D016903:Drug Monitoring; D005260:Female; D005602:France / Q000453:epidemiology; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000517:prevention & control; D007003:Hypoglycemia / Q000453:epidemiology / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D015918:Infusion Pumps, Implantable / Q000009:adverse effects*; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use; D007332:Insulin Infusion Systems / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human