[Long-term therapy with the insulin pump]

The author treated for prolonged periods 179 diabetics type I and II using an insulin pump. The shortest period of treatment was 6 months, the longest three years. Treatment failed only in six patients, i.e. in 3.3%, in all instances because they were incapable of adhering to the dietetic regime or to control the function of the pump. Complications had also mainly technical reasons, in 43 patients the pump failed and had to be replaced. Indicators of metabolic compensation reached normal levels in 173 patients and the triacylglycerol and cholesterol blood levels declined significantly. Laboratory hypoglycaemia was recorded in all patients, hypoglycaemia with clinical symptoms only in 17 patients. As to specific complications of diabetes, proteinuria and neuropathy were influenced most favourably. Long-term treatment with an insulin pump is useful in type I diabetes with metabolic lability and in obese type II diabetics where weight reduction is essential because of insulin resistance. So far the effectiveness of treatment with a pump to suppress permanently progression of specific complications is controversial.