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SHR Neuro Cancer Cardio Lipid Metab Microb

Hauzenberger, JR; Hipszer, BR; Loeum, C; McCue, PA; DeStefano, M; Torjman, MC; Kaner, MT; Dinesen, AR; Chervoneva, I; Pieber, TR; Joseph, JI.
Detailed Analysis of Insulin Absorption Variability and the Tissue Response to Continuous Subcutaneous Insulin Infusion Catheter Implantation in Swine.
Diabetes Technol Ther. 2017; 19(11):641-650 Doi: 10.1089/dia.2017.0175 [OPEN ACCESS]
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Leading authors Med Uni Graz: Kastner Jasmin
Co-authors Med Uni Graz: Pieber Thomas
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Abstract:: Worldwide, ∼1 million people manage their type 1 diabetes with an insulin pump and a continuous subcutaneous insulin infusion (CSII) catheter. Patients routinely insert a new catheter every 2-3 days due to increasing variability of insulin absorption over time. Catheter insertion and maintenance damage capillaries, lymphatics, cells, and connective tissue leading to an acute inflammatory response. We compared an investigational CSII catheter (IC) and a commercial CSII catheter (CC) regarding insulin absorption pharmacokinetics (PK) and tissue inflammation. The two different catheter designs were implanted into the subcutaneous tissue of six swine for 5 days. Insulin boluses were given on days 1, 3, and 5 of wear-time to assess PK. Tissue around catheters was excised and stained to visualize inflammation and morphological changes of adjacent tissue. Insulin absorption was better when infused through a CC with highest C_max and fastest t_max values on day 5 of catheter wear-time. Both catheter types produced high intra- and intersubject day-to-day insulin absorption variability. The IC caused significantly more tissue disruption and lead to irregular changes in tissue morphology. Both catheter types were surrounded by a layer of inflammatory tissue that varied in composition, thickness, and density over time. A catheter that was manually inserted by pushing a sharp tip through the skin caused more trauma and variability than a 90° Teflon cannula with automated insertion. Insulin absorption variability could be attributed to the layer of inflammatory tissue, which may function as a mechanical barrier to insulin flow into adjacent vascular tissue. The impact of the acute inflammatory tissue response on insulin absorption has to be considered in future catheter designs. A catheter that was manually inserted by pushing a sharp tip through the skin caused more trauma and variability than a 90° Teflon cannula with automated insertion.
Find related publications in this database (using NLM MeSH Indexing): Animals -; Catheters, Indwelling -; Female -; Hypoglycemic Agents -; Inflammation - etiology; Insulin - administration & dosage; Insulin - pharmacokinetics; Insulin Infusion Systems - adverse effects; Subcutaneous Tissue - drug effects; Swine -
Find related publications in this database (Keywords): CSII therapy; Insulin absorption variability; Inflammatory response; Adipose tissue inflammation; Insulin pharmacokinetics; CSII catheter