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James Watson wrote:
> As much as I would like to see this work, I am leary of the
> prospect. Even the fastest insulin, Lispro, has an
> activation of 2 hours. Integrating the bg meter into the
> control program for the pump will be very difficult. It
> will need to know what the patient has done and the
> direction that their bg is traveling as it makes its
> decisions. For instance: you have a bg which starts a
> climb. The pump starts to add more insulin. The bg will
> continue to climb, because the insulin that the pump has
> delivered won't reach the bloodstream for 2 hours. If the
> pump continues to deliver insulin in reaction to the rising
> bg, the liklihood of a subsequent hypo is high.
> It will be very interesting (difficult) to see how this
> control logic is implemented.
Disetronic have a permanent cannula now commercially available in
Europe. A minor surgical procedure introduces a tube which goes from the
surface of your skin to the portal vein (just upstream of the liver).
You wear an external pump, but the insulin goes directly into your blood
stream just where the pancreas normally delivers it. Perfection.
Extraordinary care must be taken though with cleanliness to prevent
liver infections. The continuous bg monitor would be ideal for
controlling this type of system.
The Disetronic system of continuous gradual delivery would work nicely,
but I can't see the MiniMed pump technology being used here, since the
the 0.1 unit boluses would create large peaks and troughs in blood
insulin concentration, unless they used a very dilute insulin - perhaps
U10. But then you would only get 30 units in a 3ml cartridge. Hardly
enough to get you through the day.
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Insulin-Pumpers website http://www.bizsystems.com/Diabetes/