• Item type: Scientific article
• Country: United States
• Language: English
• Author: Sara Wilson Reece and Cheryl Lynn Hamby Williams
• Publication Date: May, 2014
• http://spectrum.diabetesjournals.org/content/27/2/135.extract

In the early 1960s, Dr. Arnold Kadish developed the first insulin pump, which was the size of a Marine backpack. Over the years, insulin pumps have become much more refined and have decreased in bulk to the size and weight of a small pager. Insulin pump therapy, also known as continuous subcutaneous insulin infusion, is no longer seen as experimental and controversial, but rather is viewed as an acceptable alternative to multiple daily injection (MDI) therapy in the management of insulin-dependent diabetes.

The insulin pump is an electromechanical device that mimics the body's natural insulin secretion from pancreatic β-cells by subcutaneously delivering rapid-acting insulin both at preset continuous basal rates and in extra bolus doses at mealtimes on demand. Insulin pumps allow for up to 24 different hourly basal rates in a 24-hour period. For bolus doses, pump users input their current blood glucose level and the number of carbohydrates they will consume, and the pump customizes their dose based on insulin currently on board (i.e., the remaining active insulin from the previous dose), their individualized insulin-to-carbohydrate ratio, and their individualized insulin sensitivity factor (i.e., their expected drop in blood glucose from 1 unit of insulin). Thus, insulin pumps are able to deliver insulin in a more physiological manner than other injection-based insulin regimens.

In the late 1970s, results of the first human trials of insulin pump therapy were published. This was followed by numerous additional studies comparing insulin pump therapy to traditional MDI regimens with regard to long-term glycemic control and minimization of hypoglycemia. Then, in 1993, the Diabetes Control and Complications Trial confirmed the importance of intensive glycemic control using either insulin pump therapy or an MDI regimen along with frequent self-monitoring of …

This library item was referred to by the moderator of the following discussion: Education for insulin pump use