Intraperitoneal insulin infusion: treatment option for type 1 diabetes resulting in beneficial endocrine effects beyond glycaemia

• Published in: Clinical endocrinology (Oxford) Vol. 81; no. 4; pp. 488 - 497
• Main Authors: van Dijk, P.R., Logtenberg, S.J.J., Gans, R.O.B., Bilo, H.J.G., Kleefstra, N.
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell Publishing Ltd 01-10-2014; Blackwell; Wiley Subscription Services, Inc
• Subjects: Biological and medical sciences; Blood Glucose - drug effects; Diabetes; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - drug therapy; Diabetes Mellitus, Type 1 - physiopathology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Fundamental and applied biological sciences. Psychology; Humans; Hyperglycemia; Infusions, Parenteral; Insulin; Insulin - administration & dosage; Insulin - therapeutic use; Medical sciences; Quality of Life; Vertebrates: endocrinology; Endocrinopathy; Intraperitoneal; Immunopathology; Pancreatic hormone; Endocrine gland; Treatment; Type 1 diabetes; Perfusion; Autoimmune disease; Insulin; Endocrinology; Glycemia
• ISSN: 0300-0664; 1365-2265
• DOI: 10.1111/cen.12546

Summary
Continuous intraperitoneal insulin infusion (CIPII) is a treatment option for patients with type 1 diabetes mellitus who fail to reach adequate glycaemic control despite intensive subcutaneous (SC) insulin therapy. CIPII has clear advantages over SC insulin administration in terms of pharmacokinetic and pharmacodynamic properties and has been shown to improve glycaemic regulation. Due to the delivery of insulin predominantly in the portal vein, as opposed to systemically, CIPII offers a unique research model to investigate the effects of insulin on endocrine and metabolic parameters in vivo. The aim of the present article is to provide an overview of the literature with respect to the effects of CIPII on glucose management, quality of life, complications and costs, with additional focus on metabolic and endocrine aspects. Finally, future use and research objectives are discussed.