Some insulin-dependent diabetics may benefit from insulin delivery by a pump for continuous subcutaneous infusion.


Reasons to consider insulin pump therapy for a patient:

(1) history of severe hypoglycemia

(2) history of significant hypoglycemia unawareness

(3) strong desire for a flexible lifestyle

(4) marked variability in blood glucose from day to day

(5) dawn phenomenon (nocturnal hypoglycemia with elevated fasting glucose on arising) not responding to insulin dose adjustments

(6) hemoglobin A1c above target value despite optimum management (> 7% if nonpregnant; > 6% if pregnant)


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