The Implantable Insulin Pump

  • Pauline SchaepelynckEmail author


The implantable insulin pump is a treatment option for certain patients with type 1 diabetes when an external insulin pump has failed to stabilize their diabetes despite all appropriate medical and educational efforts. The implanted pump provides an added efficacy for glycemic variability, hypoglycemia, and HbA1c as compared to the external pump’s subcutaneous insulin delivery. This is due to the intraperitoneal insulin administration which is now shown to have long-term and sustainable metabolic benefits. Insulin treatment using an implanted pump is a result of over 30 years of progress in technology and insulin preparation. While its history is made of both successes and problems, recent developments suggest a more optimistic future for disseminating this therapeutic modality.


  1. 1.
    Schade DS, Eaton RP, Davis T, et al. The kinetics of peritoneal absorption. Metabolism. 1981;30(2):149–55.CrossRefGoogle Scholar
  2. 2.
    Schade DS, Eaton RP, Friedman NM, Spencer WJ. Normalization of plasma insulin profiles with intraperitoneal insulin infusion in diabetic man. Diabetologia. 1980;19(1):35–9.CrossRefGoogle Scholar
  3. 3.
    Schaepelynck Belicar P, Vague P, Lassmann-Vague V. Reproducibility of plasma insulin kinetics during intraperitoneal insulin treatment by programmable pumps. Diabetes Metab. 2003;29:344–8.CrossRefGoogle Scholar
  4. 4.
    Oskarsson PR, Lins PE, Backman L, Adamson UC. Continuous intraperitoneal insulin infusion partly restores the glucagon response to hypoglycemia in type 1 diabetic patients. Diabetes Metab. 2000;26:118–24.PubMedGoogle Scholar
  5. 5.
    Broussolle C, Jeandidier N, Hanaire-Broutin H, for the Evadiac Study Group. French multicenter experience with implantable insulin pumps. Lancet. 1994;343:514–5.CrossRefGoogle Scholar
  6. 6.
    Hanaire-Broutin H, Broussolle C, Jeandidier N, et al. Feasibility of intraperitoneal insulin therapy with programmable implantable pumps in IDDM: a multicenter study. Diabetes Care. 1995;18:388–92.CrossRefGoogle Scholar
  7. 7.
    Jeandidier N, Selam JL, Renard E, et al. Decreased severe hypoglycaemia frequency during intraperitoneal insulin infusion using programmable implantable pumps. Diabetes Care. 1996;19:780.CrossRefGoogle Scholar
  8. 8.
    Catargi B, Meyer L, Melki V, Renard E, Jeandidier N, for the EVADIAC Study Group. Comparison of blood glucose stability and HbA1c between implantable insulin pumps using U400 HOE 21PH insulin and external pumps using lispro in type 1 diabetic patients: a pilot study. Diabete Metab. 2002;28:133–7.PubMedGoogle Scholar
  9. 9.
    Logtenberg SJ, Kleefstra N, Houweling ST, et al. Improved glycemic control with intraperitoneal versus subcutaneous insulin in type 1 diabetes. A randomized controlled trial. Diabetes Care. 2009;32(8):1372–7.CrossRefGoogle Scholar
  10. 10.
    Schaepelynck P, Renard E, Jeandidier N, et al. A recent survey confirms the efficacy and the safety of implanted insulin pumps during long-term use in poorly controlled type 1 diabetes patients. Diabetes Technol Ther. 2011;13(6):657–60.CrossRefGoogle Scholar
  11. 11.
    Van Dijk PR, Logtenberg SJ, Groenier KH, Gans RO, Kleefstra N, Bilo HJ. Continuous intraperitoneal insulin infusion in type 1 diabetes: a 6-year post trial follow-up. BMC Endocr Disord. 2014;14:30.CrossRefGoogle Scholar
  12. 12.
    Hanaire-Broutin H, Sallerin-Caute B, Poncet MF, et al. Effect of intraperitoneal insulin delivery on growth hormone binding protein, insulin-like growth factor (IGF)-1 and IGF-binding protein-3 in IDDM. Diabetologia. 1996;39:1498–504.CrossRefGoogle Scholar
  13. 13.
    Hedman CA, Frystyk J, Lindström T, Oskarsson P, Arnqvist HJ. Intraperitoneal insulin delivery to patients with type 1 diabetes results in higher serum IGF-1 bioactivity than subcutaneous insulin infusion. Clin Endocrinol. 2014;81:58–62.CrossRefGoogle Scholar
  14. 14.
    Dal S, Jeandidier N, Schaschkow A, et al. Portal or subcutaneous insulin infusion: efficacy and impact on liver inflammation. Fundam Clin Pharmacol. 2015;29:48–98.CrossRefGoogle Scholar
  15. 15.
    Buchwald H, Barbosa J, Varco RL, et al. Treatment of a type II diabetic by a totally implantable insulin infusion device. Lancet. 1981;1(8232):1233–5.CrossRefGoogle Scholar
  16. 16.
    Saudek CD, Selam JL, Pitt HA, et al. A preliminary trial of the programmable implantable medication system for insulin delivery. N Engl J Med. 1989;321(9):574–9.CrossRefGoogle Scholar
  17. 17.
    Grau U, Saudek CD. Stable insulin preparation for implanted insulin pumps. Laboratory and animal trials. Diabetes. 1987;36:1453–9.CrossRefGoogle Scholar
  18. 18.
    Renard E, Schaepelynck P, on behalf of the EVADIAC Group. Implantable insulin pumps. A position statement about their clinical use. Diabetes Metab. 2007;33(2):1 58–66.CrossRefGoogle Scholar
  19. 19.
    Schaepelynck P, Riveline JP, Renard E, et al. Assessment of a new insulin preparation for implanted pumps used in the treatment of type 1 diabetes. Diabetes Technol Ther. 2014;16(9):582–9.CrossRefGoogle Scholar
  20. 20.
    Spaan N, Teplova A, Stam G, Spaan J, Lucas C. Systematic review: continuous intraperitoneal insulin infusion with implantable insulin pumps for diabetes mellitus. Acta Diabetol. 2014;51:339–51.CrossRefGoogle Scholar
  21. 21.
    Haardt MJ, Selam JL, Slama G, et al. A cost-benefit comparison of intensive management with implantable pumps versus multiple subcutaneous injections in patients with type 1 diabetes. Diabetes Care. 1994;17(8):847–51.CrossRefGoogle Scholar
  22. 22.
    Selam JL, Raccah D, Jeandidier N, Lozano JL, Waxman K, Charles MA. Randomized comparison of metabolic control achieved by intraperitoneal insulin infusion with implantable pumps versus intensive subcutaneous insulin therapy in type 1 diabetic patients. Diabetes Care. 1992;15(1):53–8.CrossRefGoogle Scholar
  23. 23.
    Van Dijk PR, Groenier KH, DeVries JH, et al. Continuous intraperitoneal insulin infusion versus subcutaneous insulin therapy in the treatment of type 1 diabetes: effects on glycemic variability. Diabetes Technol Ther. 2015;17(6):379–84.CrossRefGoogle Scholar
  24. 24.
    DeVries JH, Eskes SA, Snoek FJ. Continuous intraperitoneal insulin infusion in patients with ‘brittle’ diabetes: favourable effects on glycaemic control and hospital stay. Diabet Med. 2002;19(6):496–501.CrossRefGoogle Scholar
  25. 25.
    Logtenberg SJ, Kleefstra N, Houweling ST, Groenier KH, Gans RO, Bilo HJ. Health-related quality of life, treatment satisfaction, and costs associated with intraperitoneal versus subcutaneous insulin administration in type 1 diabetes: a randomized controlled trial. Diabetes Care. 2010;33(6):1169–72.CrossRefGoogle Scholar
  26. 26.
    Olsen CL, Chan E, Turner DS, et al. Insulin antibody responses after long-term intraperitoneal insulin administration via implantable programmable insulin delivery systems. Diabetes Care. 1994;17(3):169–76.CrossRefGoogle Scholar
  27. 27.
    Jeandidier N, Boivin S, Sapin R, et al. Immunogenicity of intraperitoneal insulin infusion using programmable implantable devices. Diabetologia. 1995;38(5):577–84.CrossRefGoogle Scholar
  28. 28.
    Lassmann-Vague V, Belicar P, Raccah D, Vialettes B, Sodoyez JC, Vague P. Immunogenicity of long-term intraperitoneal insulin administration with implantable programmable pumps. Metabolic consequences. Diabetes Care. 1995;18(4):498–503.CrossRefGoogle Scholar
  29. 29.
    Spaan N, Teplova A, Renard E, Spaan J. Implantable insulin pumps: an effective option with restricted dissemination. Lancet Diabetes Endocrinol. 2014;2(5):358–60.CrossRefGoogle Scholar
  30. 30.
    Dassau E, Renard E, Place J, et al. Intraperitoneal insulin delivery provides superior glycaemic regulation to subcutaneous insulin delivery in model predictive control-based fully-automated artificial pancreas in patients with type 1 diabetes: a pilot study. Diabetes Obes Metab. 2017;19(12):1698–705.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of DiabetologyMarseille University HospitalMarseilleFrance

Personalised recommendations