Favourable serum calcification propensity with intraperitoneal as compared with subcutaneous insulin administration in type 1 diabetes

van Dijk, P. R., Waanders, F., Pasch, A., Logtenberg, S. J. J., Vriesendorp, T., Groenier, K. H., Hillebrands, J-L., Kleefstra, N., Gans, R. O. B., van Goor, H. & Bilo, H. J. G., 3-Mar-2020, In : Therapeutic advances in endocrinology and metabolism. 11, 11 p.

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Serum calcification propensity can be monitored using the maturation time of calciprotein particles in serum (T-50 test). A shorter T-50 indicates greater propensity to calcify; this is an independent determinant of cardiovascular disease. As the intraperitoneal (IP) route of insulin administration mimics the physiology more than the subcutaneous (SC) route in persons with type 1 diabetes (T1DM), we hypothesized that IP insulin influences determinants of calcium propensity and therefore result in a longer T-50 than SC insulin administration.


Prospective, observational case-control study. Measurements were performed at baseline and at 26 weeks in age and gender matched persons with T1DM.


A total of 181 persons, 39 (21.5%) of which used IP and 142 (78.5%) SC insulin were analysed. Baseline T-50 was 356 (45) minutes. The geometric mean T-50 significantly differed between both treatment groups: 367 [95% confidence interval (CI) 357, 376] for the IP group and 352 (95% CI 347, 357) for the SC group with a difference of -15 (95% CI -25, -4) minutes, in favour of IP treatment. In multivariable analyses, the IP route of insulin administration had a positive relation on T-50 concentrations while higher age, triglycerides and phosphate concentrations had an inverse relation.


Among persons with T1DM, IP insulin administration results in a more favourable calcification propensity time then SC insulin. It has yet to be shown if this observation translates into improved cardiovascular outcomes.

Original languageEnglish
Number of pages11
JournalTherapeutic advances in endocrinology and metabolism
Publication statusPublished - 3-Mar-2020


  • cardiovascular, insulin, intraperitoneal, phosphate, serum calcification propensity, subcutaneous, T-50, type 1 diabetes mellitus, VASCULAR CALCIFICATION, GLYCEMIC CONTROL, MEDICAL-RESEARCH, MELLITUS, ABSORPTION, DELIVERY, THERAPY, DISEASE, STATISTICS, METABOLISM

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ID: 120142003