Abstract
Studies in diabetic patients have demonstrated that approximately one-half of the insulin delivered intraperitoneally by bolus injection appears in the systemic circulation (I). Since the insulin is absorbed from the peritoneal cavity via the hepatic portal system and the portal vein is the site of entry for pancreatic insulin, it seems likely that this would be a physiologic delivery route for a mechanical pancreas with insulinization of liver and without peripheral hyperinsulinemia (2) . Diabetic patients with renal failure treated by continuous ambulatory peritoneal dialysis seem ideal candidates for intraperitoneal insulin administration. Clinical results with this method of glucose control appear superior to subcutaneous injections, although usually higher daily insulin doses are needed than those given by the subcutaneous route (3-6). Higher insulin requirements could be the result of a variety of mechanisms such as (a) substantial binding
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