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Management – Diabetes

Bruttomesso D, Crazzolara D, Maran A et al.

University of Padova, Padova, Italy.

 Diabet Med 2008;25:326–32.

[2] Quality of life and treatment satisfaction in adults with type 1 diabetes: a comparison between continuous subcutaneous insulin infusion and multiple daily injections.

Nicolucci A, Maione A, Franciosi M et al.

Consorzio Mario Negri Sud, Santa Maria Imbaro, Italy.

 Diabet Med 2008;25:213–20.

[3] Comparison of continuous subcutaneous insulin infusion (CSII) and multiple daily injections (MDI) in paediatric type 1 diabetes: a multicentre matched-pair cohort analysis over 3 years.

Jakisch BI, Wagner VM, Heidtmann B et al.

Catholic Children’s Hospital Wilhelmstift, Hamburg, Germany.

 Diabet Med 2008;25:80–5.

[4] Quantifying the impact of a short-interval interruption of insulin-pump infusion sets on glycemic excursions.

Zisser H.

Sansum Diabetes Research Institute, Santa Barbara, CA, USA.

 Diabetes Care 2008;31:238–9.

Editor’s note: Continuous subcutaneous insulin infusion (CSII) using external pumps is an increasingly common mechanism for insulin delivery in type 1 diabetes. Although in the 1980s this delivery system was associated with technical difficulties, its reliability over the subsequent decades has improved to a point where it may be described as the “gold standard” for approximating physiological insulin delivery in people with type 1 diabetes outside of a clinical environment. However, efforts to calculate the absolute risks and benefits of CSII pump therapy for individual patients have been a continual challenge. Clearly, the simple measurement of glycated hemoglobin (HbA1c) levels is a very blunt tool for this assessment, as outcome often depends upon the initial indications for switching insulin delivery systems (hypoglycemia vs. hyperglycemia).

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