Management of "brittle" diabetes with a preprogrammable implanted insulin pump delivering intraperitoneal insulin.
 OBJECTIVE--Glycaemic control in a young woman with "brittle" diabetes.
 DESIGN--Use of a preprogrammable fully implanted pump (Infusaid) to deliver insulin intraperitoneally at variable rates, giving a total dose of about 60 units/24 h.
 SETTING--Endocrinology department in a teaching hospital.
 PATIENT--Thirty year old woman with 15 years' history of "brittle" diabetes.
 MAIN OUTCOME MEASURES--Glycated haemoglobin concentration; plasma glucose concentration.
 RESULTS--After implantation of the pump there was an immediate and sustained improvement in diabetic control.
 The patient's glycated haemoglobin concentration decreased from 15.2% to 9.2% over seven months.
 Her daily glucose concentrations were in the range 3.5-12 mmol/l.
 She has not been admitted to hospital since implantation of the pump, which was eight months before the time of writing.
 CONCLUSION--The implanted programmable intraperitoneal insulin pump may be of value in the management of patients with "brittle" diabetes in whom other attempts at glycaemic control have failed.
