Abstract
<h3>To the Editor.—</h3> We read with interest the report by Mecklenburg and colleagues<sup>1</sup>of their experience of acute complications associated with insulin pump therapy. We have also recently presented<sup>2</sup>an audit of the frequency of diabetic ketoacidosis and hypoglycemic coma during our use of continuous subcutaneous insulin infusion (CSII) in all 121 patients treated by this technique in our unit since 1977.<sup>3</sup>We would, therefore, like to comment on the Seattle group's findings. The frequency of ketoacidosis during CSII treatment at Guy's Hospital was one episode per 266 patient-months, during a total of 1,628 patient-months' experience, representing seven episodes in eight years, a considerably lower frequency than that reported from Seattle. This frequency of ketoacidosis during long-term CSII was no greater than in a group of patients matched for age, duration of diabetes, and the presence and severity of complications treated by conventional insulin injection therapy at
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