Objective: In Type 1 diabetic patients, the replacement of sc insulin infusion with intraperitoneal insulin infusion restores the normal physiological gradient between the portal vein and the peripheral circulation, which is likely to modify lipoprotein metabolism.

Design: To check this hypothesis, we performed 2 apolipoprotein (apo) B100 kinetic studies in 7 Type 1 diabetic patients : first under sc insulin infusion and then 3 months after the beginning of intraperitoneal insulin infusion.

Results: Glycemic control was similar under sc insulin infusion and intraperitoneal insulin infusion as assessed by glycated hemoglobin A1c and the capillary glycemic curve performed during the kinetic study. Very low and intermediate density lipoprotein apoB100 pool size, production rate and fractional catabolic rate were similar under sc insulin infusion and intraperitoneal insulin infusion. Low density lipoprotein apoB100 fractional catabolic rate tended to decrease under intraperitoneal insulin (0.45 ± 0.06 vs. 0.55 ± 0.11 pool.d^-1), but the difference did not reach statistical significance (95% confidence interval for the difference : (-0.33, 0.11)). Low density lipoprotein apoB100 pool size and production rate remained unchanged under intraperitoneal insulin infusion compared with sc insulin infusion.

Conclusion: In Type 1 diabetic patients, the replacement of sc insulin infusion with intraperitoneal insulin infusion does not induce profound modifications of apoB100-containing lipoprotein production and fractional catabolic rates.