The treatment with portable insulin delivery systems of carefully selected, highly motivated patients who have insulin-dependent diabetes mellitus is a practical, safe, and effective means of achieving and maintaining long-term normoglycemia. However, to be effective, insulin device therapy must be used an an adjunct to good diet and exercise programs, and frequent self-monitoring of capillary blood glucose levels must be done. A 'team approach' to treatment, with the patient being responsible for self care, is a most effective method to achieve this goal. While the long-term effects of this form of treatment with respect to the development of the microvascular complications of diabetes are unknown, treatment with portable insulin infusion devices can correct many of the metabolic and hormonal abnormalities of diabetes present in patients on conventional forms of treatment. The major complication of this form of therapy is hypoglycemia, which often occurs at night. The use of reasonable therapeutic goals reduces this risk.
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