Prolonged peritoneal insulin infusion in a diabetic man.

Abstract

This study examines the feasibility of prolonged (5-day) peritoneal insulin administration in an insulindependent diabetic subject. Regular insulin was delivered through a 22-gauge polyethylene catheter into the peritoneal space by a portable, rotary solenoid pump at a concentration of 60 ∪/ml. The protocol permitted normal daily activities and attendance at work. At night, the diabetic subject slept in the Clinical Research Center, which allowed frequent monitoring of plasma glucose concentration. Blood samples were obtained every 2 h throughout the 5-day period for glucose, insulin, and C-peptide assay. The results of this study were compared with a control, subcutaneous insulin injection study completed during an additional 5-day period. The results suggest that 5-day intraperitoneal insulin infusion is superior to a comparative 5-day period of subcutaneous insulin injection. Not only were large swings in plasma glucose concentration prevented by intraperitoneal insulin delivery but also mean blood glucose concentration was reduced significantly. Furthermore, intraperitoneal insulin administration resulted in acute meal-related increases in plasma free insulin concentration, suggestive of a normal plasma insulin profile. Thus, intraperitoneal insulin may be a rational insulin delivery site for long-term insulin delivery by a mechanical insulin delivery device.