Importance of early postprandial insulin delivery in insulin-dependent diabetics

On the way to the automated (blood) glucose regulation in diabetes: the dark past, the grey present and the rosy future. XII Congress of the International Diabetes Federation, Madrid, 22-28 September 1985

The development of the artificial pancreas represents an important step forward in modern diabetology. The practical and theoretical findings obtained by its application to Type 1 (insulin-dependent) diabetic patients has given new insights into modes of insulin secretion, pathophysiology of diabetes mellitus, and new forms of treatment, i.e. the development of portable insulin pumps and intensified conventional insulin therapy. All of these therapies provided better results than conventional insulin administration. However, there is no doubt that the restoration of normoglycaemia in a real sense is obtainable only by an implantable artificial pancreas or pancreas transplantation. The development of the implantable artificial pancreas, on the other hand, is dependent upon the development of a reliably working permanently implantable glucose sensor. The first attempts in that direction have opened new vistas as to the differences between blood and interstitial tissue glucose measurements, displaying different modes of regulation under normal and pathologic conditions. A number of barriers have to be overcome until the final goal has been attained: to obtain, by automated blood glucose control, narrow glycaemic fluctuations of the normal subject, and to prevent, hopefully, relentless diabetic complications.

Use of artificial pancreas and portable insulin infusion pumps in diabetes therapy: past, present, and future

The development of the artificial pancreas (AP) was an important contribution to modern diabetology. The practical and theoretical findings obtained by its application in type I diabetic patients gave rise to new forms of treatment, i.e., portable insulin pumps and intensified conventional insulin therapy. Although these therapies lead to better results than conventional insulin administration, there is no doubt that the problems of diabetes therapy can be solved only by an implantable AP or pancreas transplantation.