Diabetic Pregnancy Managed with Intraperitoneal Insulin

A woman with insulin‐dependent diabetes (IDDM) and resistance to subcutaneously injected insulin conceived while being treated with intraperitoneal (i.p.) insulin administered through a recently developed subcutaneous peritoneal access device (SPAD). She continued on this regimen during the pregnancy and at 37 weeks was delivered of a normal baby by Caesarian section. During her pregnancy, she had 2 episodes of infection of the SPAD, which were rapidly controlled by local instillation of antibiotics. Her diabetes remained under excellent control (HbA₁: 7.3–7.5%) throughout her pregnancy. This case demonstrates that in such patients i.p. administration of insulin through a SPAD is a feasible mode of management during pregnancy. 1987 Diabetes UK