PMID- 8043664
OWN - NLM
STAT- MEDLINE
DCOM- 19940901
LR  - 20200109
IS  - 0896-8608 (Print)
IS  - 0896-8608 (Linking)
VI  - 14
IP  - 2
DP  - 1994
TI  - Insulin therapy in uremic diabetic patients on continuous ambulatory peritoneal 
      dialysis; comparison of intraperitoneal and subcutaneous administration.
PG  - 127-31
AB  - OBJECTIVE: To compare, in diabetic uremic patients on continuous ambulatory 
      peritoneal dialysis (CAPD), the effects of two patterns of insulin 
      administration, four times daily subcutaneous (SC) injections and intraperitoneal 
      (IP) route, on blood glucose, insulin, lactate, beta-hydroxybutyrate and glycerol 
      levels. PATIENTS AND METHODS: We examined 6 uremic insulin-dependent diabetic 
      patients on CAPD. The two insulin regimens, SC and IP, were tested successively 
      in randomized sequence in each patient. At the end of each treatment period we 
      determined the 24-hour profiles of blood glucose, free insulin, lactate, 
      beta-hydroxybutyrate, and glycerol. RESULTS: Mean blood glucose over 24 hours (SC 
      7.21 +/- 0.61 mmol/L, IP 7.49 +/- 0.93 mmol/L), Schlichtkrull's M value, an index 
      of glycemic control and stability (SC 10 +/- 3, IP 10 +/- 5), and the blood 
      intermediate metabolites beta-hydroxybutyrate, lactate, and glycerol were similar 
      in both groups. Mean serum free insulin was significantly higher during 
      subcutaneous treatment (SC 257.4 +/- 127.2 pmol/L, IP 170.4 +/- 83.4 pmol/L, p < 
      0.001). Insulin requirements were 2.5 times greater for the intraperitoneal route 
      (SC 51 +/- 4 U/24 hours, IP 130 +/- 43 U/24 hours). CONCLUSIONS: In uremic 
      diabetic patients on CAPD, good glycemic control may be achieved either with 
      subcutaneous intensive insulin therapy or with intraperitoneal insulin 
      administration. The latter method allows reduction of circulating free insulin 
      levels, but requires a higher dose of insulin per day.
FAU - Scarpioni, L
AU  - Scarpioni L
AD  - Department of Internal Medicine, Piacenza Hospital, Italy.
FAU - Ballocchi, S
AU  - Ballocchi S
FAU - Castelli, A
AU  - Castelli A
FAU - Scarpioni, R
AU  - Scarpioni R
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - Perit Dial Int
JT  - Peritoneal dialysis international : journal of the International Society for 
      Peritoneal Dialysis
JID - 8904033
RN  - 0 (Blood Glucose)
RN  - 0 (Insulin)
SB  - IM
MH  - Blood Glucose/analysis
MH  - Diabetes Mellitus, Type 1/blood/*drug therapy
MH  - Diabetic Nephropathies/*therapy
MH  - Female
MH  - Humans
MH  - Injections, Subcutaneous
MH  - Insulin/*administration & dosage/therapeutic use
MH  - Male
MH  - Middle Aged
MH  - *Peritoneal Dialysis, Continuous Ambulatory
MH  - Uremia/*therapy
EDAT- 1994/01/01 00:00
MHDA- 1994/01/01 00:01
CRDT- 1994/01/01 00:00
PHST- 1994/01/01 00:00 [pubmed]
PHST- 1994/01/01 00:01 [medline]
PHST- 1994/01/01 00:00 [entrez]
PST - ppublish
SO  - Perit Dial Int. 1994;14(2):127-31.