Reassessment of external insulin infusion pumps.
OBJECTIVE
To discuss the potential role of continuous subcutaneous insulin infusion (CSII) therapy in patients with insulin-dependent diabetes mellitus (IDDM).


METHODS
Published studies describing intensive insulin therapy are reviewed and evaluated.


RESULTS
CSII delivers insulin at a preset basal rate and at bolus doses, when needed, throughout the day. Although this technology allows for greater lifestyle flexibility, the risks of hypoglycemia and ketoacidosis are also increased if the pump malfunctions. Studies have shown that CSII therapy may offer some advantages over conventional insulin therapy; however, the full impact of these benefits has yet to be determined. The National Institutes of Health has recommended seven commercially available insulin pumps for patient use. Cost ranges between $2000 and $3500; the average lifespan is about five years.


CONCLUSIONS
CSII may be a viable alternative to multiple daily injections for maintaining glycemic control in patients with IDDM who require intensive insulin therapy.
Hotta
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Agency for Health Care Policy Research, Public Health Service, Washington, DC.
Adams
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D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy; D006801:Humans; D007260:Infusion Pumps / Q000191:economics / Q000592:standards*; D007328:Insulin / Q000008:administration & dosage*; D013673:Technology Assessment, Biomedical; D014481:United States