A 22-yr-old diabetic female is described who developed insulin resistance due to subcutaneous (and intramuscular) "malabsorption" of insulin resulting in recurrent ketoacidosis and sepsis. Intravenous insulin sensitivity was maintained. Diverse attempts to prevent metabolic decompensation by "external" methods failed. The insulin resistance was treated successfully by a totally implantable insulin infusion device ("INFUSAID") with no episodes of ketoacidosis in the 6 months following implantation. With this constant rate insulin infusion pump, and no supplementation of insulin dose by other means, the plasma glucose control is excellent and serum lipid and glycosylated haemoglobin (HbA1) levels have returned to normal.
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