Hemorrhagic Shock Associated with a Subcutaneous Insulin Pump Catheter: First Time Reported Side Effect.

Abstract

Continuous subcutaneous insulin infusion (CSII) systems, used to treat diabetes for over 40 years may improve glycemic control but also have rare major complications. We report the first hemorrhagic shock on the infusion site of an insulin pump, due to a rectus abdominis hematoma. An eighty-one years old woman with history of cardiovascular events and type 1 diabetes, presented with hemorrhagic shock due to a rectus abdominis hematoma rapidly constituted at the insulin injection site. The situation improved after conservative treatment (blood transfusions, IV fluids, replacement of the CSII with insulin injections). Contributive factors to this complication were overdose of anticoagulant, oversized insulin canula and cough. We recommend increased monitoring of patients using insulin pump with hemorrhagic risk factors. Specific education for the prevention and detection of signs of hemorrhage should lead patients to report this situation promptly, in order to avoid this life-threatening complication.