Insulin pump therapy (continuous subcutaneous insulin infusion, CSII) is a form of intensified insulin treatment involving subcutaneous infusion of short-acting insulin from a portable pump. There is a well-established evidence base for the effectiveness of CSII in type 1 diabetes, which includes reduction in HbA1c, blood glucose variability, and all grades of hypoglycemia compared to MDI, but more research is needed on how new long-acting insulin preparations and more effective diabetes education will reduce the number who do not achieve target levels of control on MDI and who are thus candidates for CSII. Insulin pump therapy is an affordable, cost-effective therapeutic option for most healthcare settings. There is an increasing role for CSII in patients with poorly controlled type 2 diabetes who are not adequately managed on MDI, but smaller, cheaper, and simpler “patch” pumps are likely to be needed to make insulin pump therapy cost-effective in this type of diabetes.
KeywordsInsulin pump therapy Continuous subcutaneous insulin infusion CSII Type 1 diabetes Type 2 diabetes Hypoglycemia Glycemic control Intensified insulin therapy
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