Management of Diabetes Resistant to Subcutaneous Insulin with Intravenous Insulin via an Implanted Infusion Pump

Abstract

Diabetes resistant to conventional subcutaneous insulin injection is a rare complication of insulin-dependent diabetes which poses a major management problem. We report three cases treated for a total of over seven patient years with fully implanted insulin infusion devices. Technical difficulties with the devices and their operation have been substantial but the patients are much improved and hospitalisation has been dramatically reduced. We suggest that implanted insulin pumps are a real treatment option for patients with this unusual syndrome.

A diabetic odyssey: from research to guidelines. The Arnold Bloom Lecture 2002

“…Because intravenous insulin sensitivity is maintained, the first patient in the UK and indeed world‐wide to receive an implantable insulin infusion system for this syndrome had a successful outcome 18. Indeed, three such patients in Scotland received an ‘Infusaid’ implantable device to deliver insulin intravenously 19. Approximately 8–10 years later one of these brittle diabetes females died of diabetic nephropathy and the other of myocardial infarction; the third is still alive and well and ‘less brittle’.…”