Experience of long-term intraperitoneal insulin treatment using a new percutaneous access device.
A pilot study was conducted to determine the efficacy of a new percutaneous device, designed to help to deliver insulin from an external, multiprogrammable pump to the abdominal cavity in patients with Type 1 (insulin-dependent) diabetes. Six patients received intraperitoneal insulin therapy for 15-24 months, a total experience of 9.4 patient-years. Glycosylated haemoglobin stabilized at 7.6 +/- 0.7% with no change in insulin dose. Four patients had to submit to reimplantation after 30 to 60 weeks. One patient met with inconvenient location of the device and three had blockage of the system. In four patients treatment had to be interrupted due to blockage of the intraperitoneal catheter by omental-tissue encapsulation. In two of those patients this blockage was combined with deeper infections. In another patient treatment had to be interrupted due to chronic, local, subcutaneous infection.
Wredling
R
R
Department of Medicine, Danderyd Hospital, Sweden.
Adamson
U
U
Lins
P E
PE
Backman
L
L
Lundgren
D
D
D000328:Adult; D000704:Analysis of Variance; D002408:Catheters, Indwelling; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D006801:Humans; D015918:Infusion Pumps, Implantable; D007263:Infusions, Parenteral / Q000295:instrumentation; D007332:Insulin Infusion Systems; D008297:Male; D008875:Middle Aged; D010529:Peritoneal Cavity; D010865:Pilot Projects; D013997:Time Factors