From Insulin Pumps to Artificial Pancreas: Indian Experience over 12 years
Insulin pumps are time tested gadgets in use for more than 50 years. The modern day models in addition to delivering insulin continuously subcutaneously, wirelessly receives signals from continuous glucose monitors and integrates sophisticated control algorithms for automatic delivery of insulin and suspension of insulin before the onset of hypoglycemia. Due to the variable basal rates and amenities for different types of bolus delivery, a near physiological delivery of insulin is made possible resulting in reduced glucose variability. These features contribute to multiple pleotropic benefits such as disappearance of peripheral neuropathic pain, improvement in sexual dysfunction, improvement in the pain of angina and overall improvement in quality of life. With advancements in technologies and with newer rapid acting insulins, the design and function of pumps are improving at a faster pace and the first generation artificial pancreas 640G is already available in the global market including India. In this review, we are also sharing our clinical experience and the Indian evidence using Insulin pumps in type 1 and type 2 diabetes over 12 years.
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