Diabetes, intraperitoneal insulin, and CAPD

In patients on continuous ambulatory peritoneal dialysis (CAPD), hemoglobin A1 was measured in order to assess the effect of the high content of glucose in the dialysate solution. In five diabetics on CAPD, insulin was added to the dialysate in an attempt to maintain continuous control of blood glucose throughout the day. Glycosylated hemoglobin was elevated in seven diabetics prior to the initiation of CAPD (12.0 +/- 2.3%) as it was in six non-diabetics after several months on CAPD. (9.6 +/- 0.90%). With the use of intraperitoneal insulin, satisfactory control of blood glucose could be achieved and the rate of peritonitis was not increased. However, regardless of whether blood glucose was well-controlled or not, hemoglobin A1 as well as triglyceride values rose in diabetics on CAPD.