ABDOMINAL INSULIN PUMP MAY EASE PROBLEMS OF DIABETES

A hockey-puck-size insulin pump inserted under the skin can help some diabetics avoid several-times-a-day injections, keep their weight down and control their blood sugar better, researchers say.

To use the device, which is inserted in the abdomen, patients give themselves a blood test to determine how much insulin is needed, then hold a small transmitter over the pump to tell it how much to deliver. The pump then dispenses a steady trickle of inuslin rather than an all-at-once dose.The manufacturer of the pump, MiniMed Inc. of Sylmar, Calif., said it expects to receive Food and Drug Administration approval in late 1997.

MiniMed helped pay for the study, which was led by Dr. Christopher Saudek, chief of the Johns Hopkins Hospital diabetes center, and was published in Wednesday's issue of the Journal of the American Medical Association.

Researchers studied 105 men with Type II diabetes at Veterans Affairs hospitals across the country. Half used the pump several times a day for a year; the other half gave themselves injections three times a day.

The incidence of insulin reactions, or hypoglycemia, was 68 percent lower among pump patients. Hypoglycemia, or low-blood sugar, occurs in diabetics when they receive too much insulin. It can cause panic and even coma.

Dr. William Duckworth of the Omaha VA Medical Center, co-author of the study, said the pump works better because it releases insulin slowly, without causing the swings in blood sugar than an injection can cause.

Also, patients who received injections gained an average of 8 pounds, while pump patients lost an average of more than 2 pounds.

The researchers said that could be because the insulin reaches the liver more directly via the pump. Some scientists suspect that once injected into the bloodstream, some insulin is used by the body to store fat, and that contributes to weigh gain.

The pump is expected to cost about $15,000 installed and must be refilled every six to 12 weeks at a doctor's office. Saudek serves on MiniMed's advisory board but has no financial stake in the company, said MiniMed president and chief executive Terry Gregg.

Type II diabetes, the most common form of the disease, affects about 10 percent of the general population. Diabetics have difficulty processing sugar.

Although many Type II diabetics can control the disease by limiting their sugar intake, about one third are treated with insulin, which they usually inject themselves, sometimes several times a day.