Continuous intraperitoneal insulin infusion: an alternative route for insulin delivery in type 1 diabetes
Continuous intraperitoneal insulin infusion (CIPII) with implantable pump has been employed for almost 30 years as an alternative route for insulin delivery when SC insulin therapy has failed . CIPII mimics physiology more closely than standard therapies because most of the insulin is absorbed through the portal venous system. This route allows a faster, after meal, glucose normalization with reproducible and more predictable insulin profiles even than continuous subcutaneous insulin infusion (CSII); it not only improves hepatic uptake and lowers peripheral plasma insulin levels, but also optimizes glucagon secretion and hepatic glucose production. The current uses of CIPII are severe SC insulin resistance, poor glycemic control with high daily insulin doses, severe hypoglycemia during SC insulin therapy, skin disorders, SC site issues, lipoatrophy with SC insulin and “brittle diabetes” .
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Conflict of interest
The authors declare no competing interests for this manuscript.
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