Abstract

The technology associated with insulin pump therapy - continuous subcutaneous insulin infusion (CSII) - has improved greatly since the first studies of this method of exogenous insulin delivery were performed in the 1970s. Following publication of the Diabetes Control and Complications Trial, in which CSII was employed in over 40% of intensively treated subjects, centres throughout the world began to use CSII. The preferred formulation is a rapid-acting insulin analogue. Current data suggest that CSII used in this way is associated with decreases in glycated haemoglobin (HbA1C) values, reduced insulin requirements and fewer episodes of mild and severe hypoglycaemia. Successful initiation of CSII depends upon careful selection of patients and intensive education by the multidisciplinary team. Local experience has confirmed that patients who use CSII show reductions in HbA1C, experience fewer episodes of hypoglycaemia, have increased awareness of impending