Five-day programmed intraperitoneal insulin delivery in insulin-dependent diabetic man

This study examined the feasibility of continuous programmed intraperitoneal insulin infusion to maintain glycemic control in insulin-dependent, "C"-peptide-negative diabetic man over a 5-day period. The insulin was delivered via a transcutaneous ip catheter from a portable, programmable insulin delivery pump. All 10 diabetic subjects received ip insulin during the day and night, and plasma glucose, free insulin, and C-peptide concentrations were evaluated at 16 intervals throughout each 24-h period. Standard American Diabetes Association recommended diets were provided, and the insulin dosage was adjusted for both premeal glycemia and the quantity of calories ingested. All subjects maintained normal daily activities including attendance at work or school but slept in the Clinical Research Center at night. Our results demonstrate that continuous programmed ip insulin infusion can maintain glycemic control in insulin-dependent diabetic man for 5 days. Furthermore, normalization of plasma free insulin profiles can be achieved, with sharp peaks of insulin coincident with the rise in glucose at each meal. We conclude that the peritoneum may be an appropriate insulin delivery site for C-peptide-negative diabetic man.