[Status and perspectives of automated insulin therapy]

The aim of the optimization of insulin supply in insulin-dependent diabetes mellitus is by means of restoration of blood glucose regulation resembling the physiological control to contribute to the secondary prevention of the late diabetes-specific complications. An individually different permanent supply of a basic insulin dose, the adapted application of additional doses during the meals and the avoidance of an induced hyperinsulinism are to be achieved. Several apparative or biomaterial-depending techniques of an optimized insulin supply are still at the stage of technological research and of animal experiments: bioartificial (hybrid) pancreas and implantable therapeutic systems. Artificial beta-cells (feedback controlled insulin infusion systems) are hitherto commercially available only as bedside apparatuses and for this reason above all suitable for purposes of research; portable and in a few cases implantable insulin pumps (not automatically glucose-dependent controlled) are at present subject of long-term, controlled clinical-ambulatory studies on the borderline to highly specialized therapy. From experience in the use of these methods results the strategy of an "intensified conventional" insulin therapy which may be recommended for wide-spread application.