Individualism and insulin pump therapy

Excerpt

To the Editor: Nowadays, so-called ‘smart’ insulin pumps invariably have built-in features that are perceived to add benefit for users. These include: dosage calculators that manage the complex arithmetic associated with pump use; an ‘insulin-on-board’ feature that considers the amount of insulin still ‘active’ in a patient prior to recommending an insulin dosage; and the ability to programme alternative basal insulin delivery rates for corresponding times of the day and night and for different types of bolus infusion according to variations in types of foods and meal content. Other features include programmable reminders and alerts, carbohydrate databases, and so on. The increasing complexity of pumps is partly an attempt to give manufacturers a ‘market edge’ against their competitors. However, the evidence base (i.e. randomised controlled clinical trials) for including such features is generally lacking. …