Insulin Infusion Pumps for Diabetes Mellitus Treatment

Abstract

Portable insulin pumps have been used for the treatment of diabetes mellitus since the mid 1970s and are available from two manufacturers. Both are programmable syringe pumps and sell for about $3,600. Portable pumps can be a powerful tool for achieving and maintaining precise control of glycemia, but are most likely to improve quality of life in settings where paitents collaborate closely with medical professionals in the management of their disease. Implantable insulin delivery pumps are not yet FDA approved but are available in clinical trial. Decisions regarding which type I diabetic patients are suitable candidates for treatment by implantable pump cannot be meaningfully addressed at this time. Implantable pump therapy is clearly the most expensive therapeutic option; portable pump therapy is intermediate in expense, and conventional therapy is least expensive. Continuous intravenous or intraperitoneal delivery by implantable pump may provide superior metabolic control with fewer episodes of hypoglycemia. If such control retards the development of late complications, the additional cost of pump therapy will provide a favorable benefit-tocost ratio when weighed against the economic impact of diabetic complications.