1. Insulin Delivery: Pumps and Glucose Anna Zhu BME 410 11/18/04

2. The Problem: Diabetes 18.2 million people in the US estimated to have Diabetes. (2002) 130 million people worldwide. 10-25% with Type I – Insulin Dependent Diabetes Mellitus. After 5 to 20 years, Type II patients often also become insulin dependent

3. Type I Diabetes aka Insulin-dependent diabetes or juvenile- onset diabetes The body’s own immune system destroys pancreatic beta cells, the only cells that make insulin. Low levels of insulin production cannot adequately regulate blood sugar levels Can be caused by autoimmune, genetic, or environmental factors Patients must administer insulin multiple times daily, especially before meal times

4. Type II Diabetes Non insulin-dependent diabetes mellitus A problem in the way the body makes or uses insulin Can be caused by insulin resistance, obesity, high cholesterol, and high blood pressure Increased risk due to genetics, family history, environmental factors (low activity, poor diet), age, hypertension, or race/ethnicity. Treatment through dietary management, weight control, and blood glucose management Condition cannot be treated with insulin therapy

5. Insulin Hormone secreted by beta cells from the islet of Langerhans of the pancreas Response to increase in blood sugar level (ie after a meal) Promotes the transfer of glucose from blood to various body cells by binding and activating glucose receptors Aids in conversion of absorbed glucose into glycogen No Insulin = No glucose breakdown and no energy to cells

6. Insulin Production Genetically engineered insulin same as what is made in the human body. Produced by special non-disease-producing laboratory strain of Escherichia coli bacteria that is genetically altered with the gene for human insulin production. Comes in very short-acting, intermediate, and long-acting forms A single type may be used, or a mixture of two types may be used depending on the need of the patient

7. Types of Insulin TypeNamesStarts to work Peak effective- ness Duration Ultra short (clear) Lispro (Humalog) 5-15 mins45-90 mins2-4 hours Short (clear)Regular (R)30 mins2-5 hours5-8 hours Intermedicate (cloudy) NPH (N) or Lente (L) 6-12 hours 16-24 hours Long ActingUltralente (U) 4-6 hours8-20 hours24-28 hours

8. Important Factors in Choosing the Right Pump Size and Weight Insulin storage capacity Ease of Use – Menu and Operations Basal (continuous) and Bolus (before meals or high blood glucose) Rates Data and Memory Special Features

9. Current Products Animas Corp: IR 1200Deltec: Cozmo Medtronic: ParadigmDanaDiabecare: Dana

10. Animas Corporation: IR 1200 Insulin Pump Currently the world’s smallest full feature pump 2.9”x2.0”x0.76” - 3.13 oz Stores 200 units of U-100 insulin Large size menu driven interface Long battery life – 6-8 weeks with 1 AA lithium Waterproof 12 ft - 24hrs Super-low basal rate 0.025 U/hr to 25 U/hr

11. IR 1200: Special Features Download capable – ezManager Plus Nonvolatile memory Patented sensor and algorithm to detect occlusions promptly Meal bolus and BG check reminders User set near empty reminders in increments of 10 U