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[IPm] (Fwd) [peds-endo] insulin pump in pre-transplant patient

Please respond directly to Dr. Miller, he is not an ip-medpro list 

email @ redacted

------- Forwarded Message Follows -------
To:            "'email @ redacted'" <email @ redacted>
From:          "Miller, Bradley S., M.D., Ph.D." <email @ redacted>
Date:          Mon, 26 Nov 2001 08:57:58 -0600
Reply-to:      email @ redacted
Subject:       [peds-endo] insulin pump in pre-transplant patient

We have an 18 yo young man with a long history of Type I Diabetes
Mellitus with the recent development of a dilated cardiomyopathy
(presumed secondary to viral myocarditis).  During the past few
months, he has had a significant dawn phenomenon which continues
despite trying BID ultralente, hs NPH and hs glargine.  We have
discussed the use of an insulin pump in this young man. I would like
to ask this forum for experience with insulin pumps related to the

 1.  Anticoagulated patients (coumadin) and the formation of site
 2.  Infection rate of insulin pump sites in normal and
immunosuppressed patients
 3.  The use of insulin pumps in immunosuppressed patients (s/p solid
organ transplant, bone marrow transplant, chemotherapy, etc.)
 4.  Affects of these adverse events on transplant status

Thanks for your input,

Bradley S. Miller, M.D., Ph.D.
Fellow, Pediatric Endocrinology
Mayo Clinic
Rochester, MN  55905

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