title: Implantable insulin pump therapy: an unusual presentation of a catheter-related complication.
abstract: We report the case of a 63-year-old man who has a 19-year history of involvement in the implantable insulin pump program at Johns Hopkins University. After his most recent pump implantation in February 2004, his 24-h insulin requirement gradually increased from a baseline of 75 units to a peak of almost 500 units in June 2005. Surprisingly, insulin delivery from the pump and glycemic control remained satisfactory despite the dramatic change in insulin requirement. Laparotomy revealed a fibrous mass in the peritoneal cavity, with the track of the catheter extending into the mass. Insulin requirement declined post-resection of the mass and relocation of the catheter tip.
authors.affiliation: Department of Medicine, Division of Endocrinology and Metabolism, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Kevin B
authors.initials: KB
authors.lastname: Moore
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Saudek
authors.forename: Alicia
authors.initials: A
authors.lastname: Greene
authors.forename: Alan
authors.initials: A
authors.lastname: Dackiw
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002404:Catheterization / Q000009:adverse effects*; D003240:Connective Tissue Diseases / Q000139:chemically induced* / Q000601:surgery; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D007332:Insulin Infusion Systems / Q000009:adverse effects*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010529:Peritoneal Cavity; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin