Continuous Subcutaneous Insulin Infusion Therapy in Type 1 Diabetes: 2013 Clinical Guidelines and Recommendations from the Association of Clinical Endocrinologists of South Africa (Ace-Sa)

The first external insulin pump device to deliver continuous subcutaneous insulin infusion (CSII or “insulin pump”) therapy was used more than 30 years ago. Subsequently, the Diabetes Control and Complications Trial (DCCT) has convincingly demonstrated that stricter glycaemic control, using insulin delivered by multiple-dose injections (MDI) or CSII, prevents and retards the progression of microvascular complications. Technological improvements in pump design and functionality, the wider dissemination of accumulated knowledge and the desire to achieve blood glucose values as close to the normal range as possible, have resulted in a significant increase in insulin pump use throughout the world. An increasing body of evidence supports the ability of insulin pump therapy to improve glycaemic control while reducing hypoglycaemic episodes when used in appropriately selected patients with type 1 diabetes.