Use of an integrated sideport for diagnosis and management of decreased flow rates in a programmable implanted insulin delivery system. Implantable Insulin Pump Trial Study Group.

The aim of this study was to develop procedures for the diagnosis and nonsurgical management of decreased insulin flow in an implantable programmable pump for long-term intraperitoneal or intravenous insulin delivery featuring a sideport. Patency of the catheter lumen was tested by measuring the time needed for sideport pressure to decrease by 50% after the injection of 0.1 ml of buffer solution. Pumping unit performances were assessed by measuring the volume of pump pulses after diverting the pump flow at the sideport. A catheter flush with buffer solution through the sideport was effective in clearing 79% of intraperitoneal and 84% of intravenous catheter occlusions. Washing the pumping unit with an alkaline solution after diverting pump flow at the sideport was effective in dissolving insulin aggregates inside the pumping unit and in restoring normal pump flow. These procedures were associated with a 1.3% rate of hypoglycemic episodes.