CSII in type 2 diabetic patients

CSII has become an increasingly popular type of therapy for patients with type 1 diabetes. The benefits of insulin pump therapy (less glycemic variability, lower HbA1c, less incidence of severe hypoglycemia, and more flexible lifestyle with a positive impact on the quality of life) should be similar for patients with type 2 as well as type 1 diabetes. Data on the use of CSII in patients with type 2 diabetes are limited, and no large-scale, randomized, controlled trials have been published. There are well documented short-term effects (on glycemic control, insulin secretion and action, the fibrinolytic system and endothelial dysfunction) but potential long-term benefits (on micro and macro vascular complications) remain unproven. The advantages and disavantages of this type of treatment must be determined according to the different characteristics of type 2 diabetic patients and to the different phases of the disease. CSII, like all techniques for improved diabetes control should thus be made available to everyone who can benefit from it. (c) 2006 Elsevier Ireland Ltd. All rights reserved.