Diabetes resistant to conventional subcutaneous insulin injection is a rare complication of insulin-dependent diabetes which poses a major management problem. We report three cases treated for a total of over seven patient years with fully implanted insulin infusion devices. Technical difficulties with the devices and their operation have been substantial but the patients are much improved and hospitalisation has been dramatically reduced. We suggest that implanted insulin pumps are a real treatment option for patients with this unusual syndrome.
SUMMARY Six days after admission to hospital with Salmonella gastroenteritis, this patient presented with a critically ischaemic leg, having developed an iliac occlusion, and a subcutaneous Salmonella abscess in the anterior compartment of the leg. Critical limb ischaemia and abscess formation can be added to infective aortic aneurysm as vascular complications of Salmonella gastroenteritis.
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