Unusual Intravenous Application of Insulin in a Case of Patient With Juvenile Diabetes and Subcutaneous Insulin Resistance

Abstract

A 44 years old female patient suffering from juvenile diabetes, showed a subcutaneous insulin resistance. Intravenous insulin application was the therapy of choice. Due to various problems of vascular access (mainly thrombosis and infectious problems) an arterio venous shunt was implemented as a last choice. Repeated puncture and insertion of common butterfly canule led to a gnarled transformation of the used vessel. The risk of thrombosis and failing of the vascular access was evident. In the absence of alternatives we tried injection systems for subcutaneous insulin application. The advantage of these systems is lower diameters and more flexible materials, suggesting higher biocompatibility. During this therapy the gnarled transformation decreased, the blood flow in the vascular shunt improved. The use of the small (subcutaneous) infusion systems for intravascular application of insulin showed that to be a save alternative in this case. doi:10.4021/jem85w