[Treatment of resistance to subcutaneous insulin with implanted insulin infusion pumps].

Four female patients, resistant to insulin administered subcutaneously, were treated with an implanted insulin infusion pump (Infusaid; constant rate infusion). They had all experienced as many as four episodes of ketoacidosis per month despite extremely high doses of insulin injected subcutaneously or intramuscularly, and none of the treatment approaches attempted--insulin delivery via subclavian catheter, Schade-port, insulin infusion with an external portable pump or various insulin additives--had been successful. After implantation of the pump the daily insulin dose, which had been between 300 and 3000 units during subcutaneous therapy, was reduced to 30 to 70 units per day. The patients' condition improved, no further episodes of ketoacidosis occurred and hospital stays were reduced significantly. In the further course of treatment pump and catheter-related complications had to be overcome.