No increased risk for peritonitis by insulin injected into peritoneal dialysis solution bag through Coloplast

This study assessed the incidence of peritonitis that occurred when insulin was injected intraperitoneally with an insulin pen (Novo Pen) through an elastic plastic plate (Coloplast) attached to the dialysis solution bag.

A retrospective, exploratory descriptive study was used. SETTING AND SAMPLES: Seventeen patients (7 women and 10 men) with insulin-dependent diabetes mellitus (IDDM) and end-stage renal disease (ESRD), who were treated with continuous ambulatory peritoneal disease (CAPD), were studied.

All patients injected insulin intraperitoneally. The IDDM patients on CAPD were divided into Group I (n = 6, total of 143 treatment months), who injected insulin with syringes and needles via the injection site on the bags, and Group II (n = 11, total of 163 treatment months), who injected insulin with an insulin pen through a nonsterile Coloplast plate added to the dialysis solution bag by the patient. Seventeen other patients (without diabetes mellitus) on CAPD, who did not use injections, served as comparison groups and were matched by age and sex with the treatment groups: Comparison Group I (n = 6, total of 51 treatment months) and Comparison Group II (n = 11, total of 217 treatment months).

Seven episodes of peritonitis occurred in Group I versus two episodes in Group II, corresponding to one episode of peritonitis for every 20 treatment months versus one episode every 81 months for Group II (p = 0.06). There were no significant differences between Group I and the matched Comparison Group I (1 episode/25 months) nor between Group II and the Comparison Group II (1 episode/31 months).

A Coloplast device enables CAPD patients to administer insulin into the dialysis solution bag without increasing the risk for peritonitis.