Methods and systems for inhibiting foreign-body responses in diabetic patients
Methods and devices are provided for reducing a diabetic patient's foreign body immune response, including infusion site-loss and/or occlusion. Such foreign body responses are associated with the treatment of the diabetic patient where the treatment requires subcutaneous implantation of a foreign body, such as a cannula or catheter. In certain embodiments of the invention, a response-inhibiting agent is administered to a patient at the site of cannula/catheter insertion, thereby facilitating delivery of insulin to the diabetic patient and mitigating site-loss and/or occlusion over a period of time.
1 . A system for delivering insulin to a diabetic patient at a single site of infusion over a period of time, the system comprising: a medication reservoir comprising an insulin solution; a cannula adapted for subcutaneous insertion into a tissue of a diabetic patient at the single site of infusion; a fluid conduit in operable contact with the medication reservoir and the cannula and adapted to deliver insulin from the medication reservoir to the single site of infusion; a site loss mitigating agent comprising rapamycin that inhibits inflammation at the single site of infusion; and wherein the system delivers an amount of rapamycin sufficient to inhibit inflammation at the single site of infusion for a period of time of at least 4 days.
2 . The system of claim 1 , wherein the site loss mitigating agent is:
(a) disposed within a depot and adapted to contact the insulin solution as the insulin solution flows from the medication reservoir to the single site of infusion; and/or
(b) pre- or in-situ mixed with insulin and/or
(c) which coats the cannula.
3 . The system of claim 2 , wherein the depot includes a membrane and/or a filter and/or a sponge and/or a polymeric material and/or a metal comprising rapamycin.
4 . The system of claim 1 , wherein the system further comprises dextran adapted to contact the insulin solution.
5 . The system of claim 4 , wherein the dextran is administered to the patient at a concentration between 0.0005 and 0.4 mg/kg/day.
6 . The system of claim 1 , wherein the period of time is at least 4, 5, 6, 7, 8 or 9 days.
7 . The system of claim 1 , wherein the site loss mitigating agent:
(a) coats the fluid path including cannula;
(b) coats a septum and/or the inner surface within the medication reservoir; or
(c) is disposed within a transdermal patch; and/or
(d) coats the cannula, internally or externally or both.
8 . A system for delivering insulin to a diabetic patient at a single site of infusion over a period of time, the system comprising:
a medication reservoir comprising an insulin solution;
a cannula adapted for subcutaneous insertion into a tissue of a diabetic patient at the single site of infusion;
a fluid conduit in operable contact with the medication reservoir and the cannula and adapted to deliver insulin from the medication reservoir to the single site of infusion; and
a rapamycin composition that inhibits inflammation at the single site of infusion; and
wherein the system delivers an amount of rapamycin sufficient to inhibit inflammation at the single site of infusion for a period of time of at least 4 days.
9 . The system of claim 8 , wherein the system further delivers rapamycin according to at least one delivery profile including:
(a) an immediate release profile wherein the rapamycin is administered to the patient from 0 to 6 hours following insertion of the cannula; and
(b) an extended release profile wherein the response-inhibiting agent is administered to the patient for at least 48 hours following insertion of the cannula.
10 . The system of claim 8 , wherein the system further comprises dextran adapted to contact the insulin solution.
11 . The system of claim 10 , wherein the dextran is administered to the patient at a concentration between 0.0005 and 0.4 mg/kg/day.