oa Journal of Endocrinology, Metabolism and Diabetes in South Africa - New guidelines for the use of insulin infusion pumps in South Africa : a welcome document which is well overdue : guest editorial
Continuous subcutaneous insulin infusion (CSII) therapy using insulin infusion pumps has been used for over 20 years. The early mechanical insulin pumps of the last century were fraught with problems which included mechanical breakdowns, blocked cannulas and an increased incidence of ketoacidosis. These challenges resulted in large-scale abandonment of the use of CSII in this country in the 1990s. Technological improvements in pump functionality, dissemination of accumulated knowledge and the desire to achieve blood glucose values as close to the normal range as possible, have led to a significant increase in insulin pump use throughout the world. In addition, an understanding of the role played by carbohydrate counting in correctly managing appropriate insulin dosing, and an improvement in the accuracy and convenience of self-administered, home glucose monitoring meters, has allowed for more meaningful home testing of blood glucose, an absolute necessity if CSII is to be successful. 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.
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