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INSULIN PUMPS AND ARTIFICIAL PANCREAS

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I understand that there are ways of testing blood glucose without pricking the skin. Can you tell me more about them?

There are regular reports in the press about ‘non-invasive’ blood glucose monitoring devices being developed. Some of these devices are not totally non-invasive. One involves a needle being inserted under the skin for up to three days at a time so that blood glucose readings can be taken every few minutes. At the moment the readings given can be accessed only by a healthcare professional, but it is hoped that eventually people will be able to read these results for themselves. This method of monitoring could be useful if the device were attached to an insulin pump adjusting the amount of insulin administered in response to the blood glucose level. Although this is not yet possible, it is likely to be developed in the near future.

I hear that there are pumps available that can be implanted like pacemakers — is this true? What are the likely developments with insulin pumps within the next five years?

Yes, it is true that insulin pumps have been implanted into people as part of research studies and there has been some encouraging progress in this field. Although still experimental and a long way from being a standard form of treatment, there are pumps small enough to be implanted into the wall of the abdomen, where they remain for several years. One such pump is made by Min-iMed but is very expensive and not available in the UK or USA.

The pump does not have a sensor to detect glucose but simply provides background insulin at a rate that can be regulated from the outside using a small radio transmitter. This device can be used to infuse more insulin before a meal. There is a reservoir of insulin that has to be refilled through the skin with a syringe and needle but changing the batteries requires a small operation. Although it looks promising, this device is complex and expensive and remains a research procedure.

I have heard about the artificial pancreas or ‘Biostator’. Apparently this machine is capable of maintaining blood glucose at normal levels, irrespective of what is eaten. Is this true? If so, why isn’t it widely available?

The Biostator is an artificial pancreas, which measures the blood glucose concentration continuously and infuses insulin at a rate which keeps the blood glucose normal. Unfortunately these machines are the size of a domestic washing machine and are technically complex.

Their major value is for research purposes since they are quite unsuitable at present as devices for longterm control. The Biostator has been around for 30 years and throughout this time, bioengineering groups have tried but failed to reduce it to a size that would be practical for everyday use.

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