Association of insulin pump therapy with raised serum amyloid A in type I diabetes mellitus.

Serum concentrations of serum amyloid A protein, the high-density-lipoprotein-associated tissue amyloid A precursor, were determined in 29 diabetic patients receiving insulin by subcutaneous injection and in 50 receiving subcutaneous infusion pump therapy. Insulin delivered by continuous subcutaneous pumps stimulated serum amyloid A production to levels nearly six times those in normal subjects, nearly twice as much as insulin given by subcutaneous injection. 85% of patients with serum amyloid A levels greater than or equal to 10(4) ng/ml were being treated with insulin pump therapy. The relation between insulin aggregation and amyloid A in diabetes was evaluated in 1 patient; treatment with syringe-aggregated insulin resulted in a nearly 300% increase in serum amyloid A levels. The use of high-potency non-aggregating insulins in the pump treatment of type I diabetic patients may be necessary for optimum therapy.