[Progress in the field of medical devices for diabetes]

In the eighties major improvements were made in insulin injection and home blood glucose monitoring. However, in the nineties further improvements were rather disappointing. Despite considerable effort, non-invasive, continuous monitoring glucose sensors are still not ready for marketing. It will take 10-20 years before 'closed-loop systems' will appear, with the amount of insulin released by the pump adjusted automatically on the basis of the measuring results of a permanently implanted blood glucose sensor. Islet cell transplantation, if possible in a way that abolishes the need to take immunosuppressive medicines, is still under development. The number of people suffering from diabetes in the Netherlands is estimated to increase from about 285,400 in 1999 to about 400,000 in 2020. The costs of medical devices for diabetes will probably double in 2020. However, increased costs for devices may improve the quality of life and may result in decreased expenditure in other parts of health care by reducing the long-term complications.