No sign of amyloidosis in pump-treated diabetics

Serum concentrations of amyloid A (SAA) and C-reactive protein (CRP) were measured in 122 diabetic patients treated by continuous insulin infusion, 40 patients receiving conventional injection therapy and in 28 healthy controls. Of the patients on pump therapy, 63 had an implanted, constant basal rate device (36 i.p., 27 i.v.) and 59 extracorporal, portable programmable pumps (8 i.p., 3 i.v., 48 s.c.). SAA and CRP-values did not significantly differ between the diabetics, irrespective of the method of insulin substitution used, and the healthy controls. Elevated SAA-levels were either associated with raised CRP, indicating a non-specific acute phase reaction, or were markedly diminished or normalized in a six-month follow-up, in spite ongoing pump therapy. Increased SAA-concentrations did not correlate with sex or age of patients, diabetes duration, diabetes type, duration of pump treatment, route of insulin, insulin preparation, catheter material and pump model, indicating that pump treatment does not stimulate a specific amyloidogenic reaction.