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April 2, 1982

Implantation of Insulin Infusion Devices

JAMA. 1982;247(13):1866-1867. doi:10.1001/jama.1982.03320380058033

During the past several years, there has been an accumulation of evidence indicating that portable insulin infusion devices have the potential to provide an approximation of normoglycemia in the compliant, insulin-dependent diabetic patient.1-5 The greatest experience with these devices has been obtained using the subcutaneous route for insulin administration,1-3 with considerably fewer patients having been given insulin by the peripheral venous4 and intraperitoneal routes.5,6 In addition to its effect on blood glucose concentrations, continuous subcutaneous insulin infusion has been reported to normalize or improve peripheral venous concentrations of other substrates (eg, free fatty acids, ketone bodies, and amino acids)7 and hormones (glucagon and growth hormone) whose levels are often abnormal in patients treated conventionally.8,9 Whether the flux of substrates and their disposition in specific tissues are comparably affected has not been established.

Unfortunately, some serious adverse effects such as severe hypoglycemia10 and ketoacidosis