title: Management of "brittle" diabetes with a preprogrammable implanted insulin pump delivering intraperitoneal insulin.
abstract: OBJECTIVE
  Glycaemic control in a young woman with "brittle" diabetes.
  
  
  METHODS
  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.
  
  
  METHODS
  Endocrinology department in a teaching hospital.
  
  
  METHODS
  Thirty year old woman with 15 years' history of "brittle" diabetes.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors: Department of Clinical Endocrinology, Imperial College of Science, Technology and Medicine, St Mary's Hospital Medical School, London.
authors: D F
authors: DF
authors: Wood
authors: K
authors: K
authors: Goodchild
authors: P
authors: P
authors: Guillou
authors: D J
authors: DJ
authors: Thomas
authors: D G
authors: DG
authors: Johnston
mesh_terms: D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D015918:Infusion Pumps, Implantable; D007328:Insulin / Q000008:administration & dosage; D007332:Insulin Infusion Systems; D008838:Microcomputers; D010529:Peritoneal Cavity; D013997:Time Factors
chemical_list: D006442:Glycated Hemoglobin; D007328:Insulin