학술논문
New ex vivo method to objectively assess insulin spatial subcutaneous dispersion through time during pump basal-rate based administration.
Document Type
Academic Journal
Author
Jacquemier P; Institut Necker Enfants Malades (INEM), IMMEDIAB Laboratory, Université de Paris Cité, INSERM U1151, Paris, France.; Centre Explor, ALHIST - Air Liquide Healthcare, Bagneux, France.; Retory Y; LVL Médical Groupe, Lyon, France.; CIAMS, Univ. Paris-Sud, Université Paris-Saclay, 91405, Orsay Cedex, France.; CIAMS, Université d'Orléans, 45067, Orléans, France.; Virbel-Fleischman C; Centre Explor, ALHIST - Air Liquide Healthcare, Bagneux, France.; Schmidt A; Centre Explor, ALHIST - Air Liquide Healthcare, Bagneux, France.; Ostertag A; Université Paris Cité, Inserm U1132 BIOSCAR, 75010, Paris, France.; Cohen-Solal M; Université Paris Cité, Inserm U1132 BIOSCAR, 75010, Paris, France.; Service de Rhumatologie, Lariboisiere Hospital, AP-HP, 75010, Paris, France.; Alzaid F; Institut Necker Enfants Malades (INEM), IMMEDIAB Laboratory, Université de Paris Cité, INSERM U1151, Paris, France.; Dasman Diabetes Institute, Kuwait City, Kuwait.; Potier L; Institut Necker Enfants Malades (INEM), IMMEDIAB Laboratory, Université de Paris Cité, INSERM U1151, Paris, France.; Université Paris Cité, UFR de Médecine, Paris, France.; Department of Diabetology, Endocrinology and Nutrition, Bichat Hospital, APHP, Paris, France.; Julla JB; Institut Necker Enfants Malades (INEM), IMMEDIAB Laboratory, Université de Paris Cité, INSERM U1151, Paris, France.; Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie Et de Santé Publique, 75013, Paris, France.; Service of Diabetology, Endocrinology and Nutrition, Federation de Diabetologie, Lariboisiere Hospital, 2 Rue Ambroise Paré, 75010, Paris, AP-HP, France.; Gautier JF; Institut Necker Enfants Malades (INEM), IMMEDIAB Laboratory, Université de Paris Cité, INSERM U1151, Paris, France.; Université Paris Cité, UFR de Médecine, Paris, France.; Service of Diabetology, Endocrinology and Nutrition, Federation de Diabetologie, Lariboisiere Hospital, 2 Rue Ambroise Paré, 75010, Paris, AP-HP, France.; Venteclef N; Institut Necker Enfants Malades (INEM), IMMEDIAB Laboratory, Université de Paris Cité, INSERM U1151, Paris, France.; Riveline JP; Institut Necker Enfants Malades (INEM), IMMEDIAB Laboratory, Université de Paris Cité, INSERM U1151, Paris, France. jeanpierre.riveline@aphp.fr.; Université Paris Cité, UFR de Médecine, Paris, France. jeanpierre.riveline@aphp.fr.; Service of Diabetology, Endocrinology and Nutrition, Federation de Diabetologie, Lariboisiere Hospital, 2 Rue Ambroise Paré, 75010, Paris, AP-HP, France. jeanpierre.riveline@aphp.fr.
Source
Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE
Subject
Language
English
Abstract
Glycemic variability remains frequent in patients with type 1 diabetes treated with insulin pumps. Heterogeneous spreads of insulin infused by pump in the subcutaneous (SC) tissue are suspected but were barely studied. We propose a new real-time ex-vivo method built by combining high-precision imaging with simultaneous pressure measurements, to obtain a real-time follow-up of insulin subcutaneous propagation. Human skin explants from post-bariatric surgery are imaged in a micro-computed tomography scanner, with optimised parameters to reach one 3D image every 5 min during 3 h of 1UI/h infusion. Pressure inside the tubing is recorded. A new index of dispersion (IoD) is introduced and computed upon the segmented 3D insulin depot per time-step. Infusions were hypodermal in 58.3% among 24 assays, others being intradermal or extradermal. Several minor bubbles and one occlusion were observed. IoD increases with time for all injections. Inter-assay variability is the smallest for hypodermal infusions. Pressure elevations were observed, synchronised with air bubbles arrivals in the tissue. Results encourage the use of this method to compare infusion parameters such as pump model, basal rate, catheter characteristics, infusion site characteristics or patient phenotype.
(© 2023. The Author(s).)
(© 2023. The Author(s).)