Continuous subcutaneous insulin infusion systems. A new approach to management of type I diabetes

Although continuous subcutaneous insulin infusion (CSII) is not presently the most feasible method of insulin delivery for most type I diabetic patients, unquestionably it is a major therapeutic advance in recent efforts to normalize blood glucose levels in such patients. In selected, highly motivated patients, CSII therapy has been shown to be safe, effective, and physiologically reasonable. Despite the failure of prolonged CSII therapy to reverse established microangiopathic complications in all cases, normoglycemia produced with CSII may reverse early complications and prevent or minimize their development in patients treated by this method from the onset of hyperglycemia. Understanding of the importance of continuous normoglycemia to the psychologic and physical well-being of type I patients should be greatly advanced by the development and use of CSII systems.