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| Categories: History of diabetes |
| History of diabetes | |
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History of the insulin pump therapy
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At the end of the seventies, medicine created a great sensation: An insulin pump for the continuous subcutaneous insulin administration could be successfully used in type 1 diabetics. It must be emphasised that the insulin infusion was given subcutaneously. Before, scientists had tried to improve the principle of the pump (continuous small quantities of insulin) by giving high doses of insulin directly into the veins. This experiment was stopped, as the endovenous infusion caused great problems because of the injection pricks and the danger of sepsis and thrombosis. In 1976, Pickup and his team started to develop a continuous subcutaneous insulin infusion (CSII), a treatment nowadays known as insulin pump therapy. As a basis for this therapy served the new development of a battery operated perfusion syringe named “Mill Hill Infusor” that could continuously release insulin. Through some screws larger quantities of insulin, nowadays known as “bolus units”, could be transported by the pump. Since the delivering speed of the “basal rate” first was always constant, it had to be adapted with the help of saline solutions. The cannula of the catheter was subcutaneous and fixed with a plaster, while the pump was fastened with a bandage or a net. The replacement of the catheter, however, always required medical interventions that had to be realised under very sterile conditions. This treatment may seem complex but its success justified the further development of the therapy. In Germany, it was the scientists Renner and Hepp who devoted themselves to this kind of work.
In the eighties, there were a lot of important developments based on the earlier pump models. At the beginning of the decade, the Auto-Syringe AS 6C pump with variable delivering speed was developed in the United States. With the development of the Promedos pumps, Siemens was one of the first companies to create implantable pumps. Besides, the so called roller pump was introduced. The CPI 9100, launched in 1982, was one of the first insulin pumps with an individually programmable basal rate. Unfortunately – and strangely enough – it had to be adjusted every evening as there was no data memory included yet (RAM). During the eighties, more and more insulin pumps were coming out, introducing some of today’s features, for example the Nordisk Infuser, which for the first time allowed the use of pre-manufactured ampoules. The Dahedi RW 90/91, a pump that was launched in Holland in the middle of the eighties, was the first small and user-friendly insulin pump and it was mainly women who selected this model. The fault of the CPI 9100 mentioned above was eventually resolved by the Hoechst MRS1-Infusor pump. The hourly basal rate could be programmed, although the setting had to be done by a doctor. For the same pump model they also developed the first pump insulin named H-Tronin. With the addition of surface active substances, it had a more stable flow through ampoules, catheters and cannulas. The further development of the pump insulin led to the creation of today’s Insuman Infusat.
Users: The first census carried out in 1991 revealed that 4,000 persons in Germany use insulin pumps. In 1995, the number has increased to 10,000 while in 2003 it was reckoned that there are 40,000 insulin pump users in Germany and about 200,000 worldwide.
Translated by Stefanie Wagner ( Stefanie Wagner )
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