DURING the 1970s, implantation of an artificial pancreas as a potential cure for diabetes received much publicity. Recently, successful diabetic treatment with explanted insulin delivery devices1 has accelerated efforts toward total implantation.
Despite this enthusiasm, the clinical timetable for implantation in diabetic humans is unresolved. Both our group and others have successfully implanted dogs with insulin delivery systems for periods ranging from weeks to months.2,3 Advances in technology of insulin delivery systems have been so rapid that within months, remotely controlled implantable insulin delivery devices will be available to many investigators, including ourselves. With more than 5 million diabetic patients in this country, should widespread, clinical implantation of these devices begin immediately?
The answer to this question relates to the benefits vs the risks of implantation. Loss of endocrine pancreatic function (ie, insulin secretion) does not result in death, as occurs with the loss of kidney or cardiac function.