Seeking Quality Insulin Delivery For Type 1 Diabetics: As research continues into the possibility of an artificial pancreas there is new evidence to suggest that the current method of insulin delivery for Type 1 diabetics may have some flaws.
According to Marketwatch, “Researchers at Sansum Diabetes Research Institute and University of California, Santa Barbara have concluded that changing the height of a conventional insulin pump in relation to its tubing and infusion set can significantly impact expected insulin delivery rates. Such changes can occur during routine daily activities like dressing, sleeping or showering. The study, ‘Siphon Effects of Continuous Subcutaneous Insulin Infusion Pump Delivery Performance,’ evaluated the siphon or hydrostatic pressure action effects on continuous subcutaneous insulin infusion and was published in the January issue of Journal of Diabetes Science and Technology.”
The core findings of this report suggests that some of the most common insulin pumps will supply less insulin when the unit is lower than the tubing site and more insulin when the unit is above the tubing.
Marketwatch continues by quoting lead investigator Howard Zisser, MD, Director of Clinical Research and Diabetes Technology at the Sansum Diabetes Research Institute in Santa Barbara, CA, “In this study we found a pronounced siphon effect in conventional insulin pumps, which caused significant fluctuations in the accuracy of insulin delivery rates when the pump position was moved higher or lower relative to its tubing and infusion site. Insulin pump therapy allows for precise control of insulin delivery for patients with type 1 diabetes. The unintended fluctuation in insulin delivery, which may arise from pump movement during normal daily use, can increase blood glucose variability, a risk factor for the progression of complications of diabetes. The effect of hydrostatic pressure was most significant at low basal rates and therefore these findings may be particularly important for pediatric diabetes patients, who often use insulin pumps at low basal rates.”
The primary reason for the research was to identify which pump could supply the best delivery of insulin according to the actual need. While no pump was perfect the research did indicate, “The OmniPod, which has no external tubing, was the least affected by pumping orientation and direction. With the OmniPod System, the 1U/hr rate differences only ranged from 98.3% when its delivery cannula was in a level pumping position to 101.3% when the cannula was in an upward pumping position. For the 1.5U/hr rate, its differences only ranged from 96.0% in a level pumping position to 102.5% in an upward pumping position.”
The research was funded by a grant from the Insulet Corporation and was conducted by the Sansum Diabetes Research Institute, “A non-profit research center devoted to the prevention, treatment and cure of diabetes through research and education. In particular, it is known for its work on methods to detect and chart the progress of diabetes, its success in developing protocols to increase the incidence of healthy babies born to women with diabetes, and its expertise in new diabetes technology.”
The goal of this type of research is to work to hold manufacturers accountable to produce pumps with the highest degree of accuracy. By pinpointing the best it may encourage other manufacturers to work to provide pumps with a greater level of accuracy as well. It is presumed that when the artificial pancreas is available the delivery of insulin will be more accurate because no outer tubing will be required.
