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Diabetic pregnancy managed with intraperitoneal insulin.

V A Fonseca, R K Menon, P M O'Brien

    Diabetic Medicine : a Journal of the British Diabetic Association
    |January 1, 1987
    PubMed
    Summary

    Intraperitoneal insulin via a subcutaneous peritoneal access device (SPAD) effectively managed a pregnant woman with insulin-dependent diabetes (IDDM) and insulin resistance. This innovative approach ensured excellent glycemic control and a healthy baby delivery.

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    Area of Science:

    • Endocrinology
    • Reproductive Medicine
    • Medical Device Technology

    Background:

    • Insulin-dependent diabetes mellitus (IDDM) presents management challenges, particularly in pregnancy.
    • Insulin resistance necessitates alternative delivery methods beyond subcutaneous injections.
    • Subcutaneous peritoneal access devices (SPADs) offer a novel route for intraperitoneal (i.p.) insulin delivery.

    Observation:

    • A pregnant woman with IDDM and insulin resistance was managed with i.p. insulin via a SPAD.
    • She experienced two localized SPAD infections during pregnancy, successfully treated with antibiotics.
    • Excellent glycemic control was maintained throughout gestation (HbA1: 7.3-7.5%).

    Findings:

    • Pregnancy with IDDM and insulin resistance was successfully managed using i.p. insulin via a SPAD.

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  • The SPAD facilitated continuous insulin delivery, preventing complications associated with poor glycemic control.
  • Localized infections were manageable without compromising the treatment regimen.

    • Implications:

    • This case suggests i.p. insulin delivery via SPAD is a viable option for pregnant women with challenging diabetes.
    • SPAD technology may offer improved glycemic control in specific diabetic pregnancies.
    • Further research into SPADs for managing complex diabetes in pregnancy is warranted.