Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Hauzenberger, J.
Inflammatory Response to
Continuous Subcutaneous Insulin Infusion Systems
and the Effect on Insulin Absorption
PhD-Studium (Doctor of Philosophy); Humanmedizin; [ Dissertation ] 5; 2017. pp.
[OPEN ACCESS]
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Heinemann Akos
- Pieber Thomas
- Altmetrics:
- Abstract:
- Type 1 diabetes is an autoimmune disease manifested in the destruction of beta cells of the pancreas. Patients are dependent on external insulin administration and approximately 1 million manage their diabetes with an insulin pump and a continuous subcutaneous insulin infusion (CSII) catheter. Variability of insulin absorption from a CSII catheter increases over wear-time and thus catheters are recommended to be replaced every 2-3 days. Mechanisms responsible for variable insulin absorption are poorly understood and only limited data is available. This thesis aimed to elucidate the inflammatory response to CSII catheters and the pharmacokinetic variability of insulin in 2 different animal models (swine and dog). Insulin absorption and tissue response were systematically evaluated over up to 7 days of catheter wear-time. Insulin absorption was better on days 5 and 6 of wear-time compared to day 1, however, variability increases. The insertion and maintenance lead to an acute local trauma and the formation of a layer of cell and tissue debris along the insertion channel. The results of this thesis show that flexible Teflon with a blunt end is better tolerable than rigid steel with a sharp tip. Based on the tissue histology and composition of skin and subcutaneous adipose tissue, the swine is a better model for human wound healing compared with the dog. The inflammatory response needs to be taken into account for future CSII catheter design.