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Considerations for Future Clinical Application

Steven B. Leichter, MD; Mary Ellen Schreiner; L. Raymond Reynolds, MD; Teresa Bolick, PhD

Arch Intern Med. 1985;145(8):1409-1412.

Abstract
• Current debate about the use of insulin infusion pumps in the treatment of diabetes mellitus is partly attributable to a lack of available data about the long-term course of patients who use pumps. We evaluated the course of our first 20 patients treated with insulin infusion pumps. Two or more years after the inception of therapy, only half of these patients were still using the insulin infusion pump. Psychosocial stresses, which affected glycemic control, were identified retrospectively in a majority of patients, but were not appreciated when pump therapy was initiated, despite our best attempts to do so. Mean hemoglobin A_, levels decreased significantly for the entire group and for the subgroup that did not discontinue pump therapy. These results suggest that insulin pump programs must have the resources to provide appropriate support for all candidates, including unsuitable candidates, who present for treatment with insulin infusion pumps.

(Arch Intern Med 1985;145:1409-1412)

Author Affiliations
From the Kentucky Diabetes Foundation and the Humana Diabetes Center, and the Department of Medicine, University of Kentucky College of Medicine, Lexington.

Footnotes
Accepted for publication Nov 12, 1984.

Read in part before the 41st annual meeting of the American Diabetes Association, Cincinnati, June 14, 1981.

Reprint requests to Kentucky Diabetes Foundation, 120 N Eagle Creek Dr, Lexington, KY 40509 (Dr Leichter).

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