Management of "brittle" diabetes with a preprogrammable implanted insulin pump delivering intraperitoneal insulin.

Abstract

Glycaemic control in a young woman with "brittle" diabetes. Use of a preprogrammable fully implanted pump (Infusaid) to deliver insulin intraperitoneally at variable rates, giving a total dose of about 60 units/24 h. Endocrinology department in a teaching hospital. Thirty year old woman with 15 years' history of "brittle" diabetes. Glycated haemoglobin concentration; plasma glucose concentration. After implantation of the pump there was an immediate and sustained improvement in diabetic control. The patient's glycated haemoglobin concentration decreased from 15.2% to 9.2% over seven months. Her daily glucose concentrations were in the range 3.5-12 mmol/l. She has not been admitted to hospital since implantation of the pump, which was eight months before the time of writing. The implanted programmable intraperitoneal insulin pump may be of value in the management of patients with "brittle" diabetes in whom other attempts at glycaemic control have failed.