Literature DB >> 2252927

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

D F Wood1, K Goodchild, P Guillou, D J Thomas, D G Johnston.   

Abstract

OBJECTIVE: Glycaemic control in a young woman with "brittle" diabetes.
DESIGN: 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.
SETTING: Endocrinology department in a teaching hospital. PATIENT: Thirty year old woman with 15 years' history of "brittle" diabetes. MAIN OUTCOME MEASURES: Glycated haemoglobin concentration; plasma glucose concentration.
RESULTS: 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.
CONCLUSION: 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.

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Year:  1990        PMID: 2252927      PMCID: PMC1664284          DOI: 10.1136/bmj.301.6761.1143

Source DB:  PubMed          Journal:  BMJ        ISSN: 0959-8138


  12 in total

Review 1.  Brittle diabetes.

Authors:  R Tattersall
Journal:  Clin Endocrinol Metab       Date:  1977-07

Review 2.  Development of implantable insulin pumps: long is the road.

Authors:  J L Selam
Journal:  Diabet Med       Date:  1988-11       Impact factor: 4.359

3.  Long-term continuous intraperitoneal insulin treatment in brittle diabetes.

Authors:  G Pozza; D Spotti; P Micossi; M Cristallo; M Melandri; P M Piatti; L D Monti; A E Pontiroli
Journal:  Br Med J (Clin Res Ed)       Date:  1983-01-22

4.  Brittle diabetes--present concepts.

Authors:  G V Gill; S Walford; K G Alberti
Journal:  Diabetologia       Date:  1985-08       Impact factor: 10.122

5.  The kinetics of peritoneal insulin absorption.

Authors:  D S Schade; R P Eaton; T Davis; F Akiya; E Phinney; R Kubica; E A Vaughn; P W Day
Journal:  Metabolism       Date:  1981-02       Impact factor: 8.694

6.  Alternate routes of insulin delivery.

Authors:  K Irsigler; H Kritz
Journal:  Diabetes Care       Date:  1980 Mar-Apr       Impact factor: 19.112

7.  Intraperitoneal insulin for control of blood sugar in diabetic patients during peritoneal dialysis.

Authors:  K Crossley; C M Kjellstrand
Journal:  Br Med J       Date:  1971-01-30

8.  The peritoneal absorption of insulin in diabetic man: a potential site for a mechanical insulin delivery system.

Authors:  D S Schade; R P Eaton; W Spencer; R Goldman; W T Corbett
Journal:  Metabolism       Date:  1979-03       Impact factor: 8.694

9.  Experience with long-term peritoneal insulin infusion from external pumps.

Authors:  J L Selam; A Slingeneyer; S Saeidi; J Mirouze; J L Richard; M Rodier; B Daynes; H Lapinski
Journal:  Diabet Med       Date:  1985-01       Impact factor: 4.359

10.  Intraperitoneal insulin administration produces a positive portal-systemic blood insulin gradient in unanesthetized, unrestrained swine.

Authors:  J A Nelson; R Stephen; S T Landau; D E Wilson; F H Tyler
Journal:  Metabolism       Date:  1982-10       Impact factor: 8.694

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