DUNCAN S. WIGG, PhD, JOHANNA SHAPIRO, PhD, MICHAEL J. PERLEY, MD, MERLE A. CHARLES, MD, PhD
Continuous subcutaneous insulin infusion (CSII) therapy has proved an effective form of treatment for many insulin dependent diabetic patients. It has been particularly efficacious in patients who have been unable to minimize rapid fluctuation of blood sugar levels or to achieve near-normal glycemia with intensive conventional insulin therapy (multiple daily injections of insulin combined with home blood glucose monitoring). Preliminary data also suggest that the improved metabolic control achieved with CSII therapy is associated with improvement in retinal fluorescein leakage, neuropathy, and capillary basement membrane thickening.
Recent reports indicate that not all patients are suitable candidates for this method of intensive insulin treatment. According to a study by Leichter et a1, many psychosocial factors play important roles in determining the success or failure of CSII therapy.