The recent ISPAD guidelines continue to suggest that insulin pump therapy is the best way to imitate the physiological insulin profile in children with Type 1 Diabetes.
However, while the insulin pump use has increased in several developed countries, this has not translated into better glycemic control in the patient populations, as several audit data and real world studies seem to suggest.
Furthermore, the insulin pump rates still vary widely (20% to 80%) across diabetes centers in countries where there are no financial constraints. Why the rates have not approached 100% even after almost 2 decades of availability of modern insulin pumps?
One, therefore, wonders if insulin pump is really the best way to deliver insulin as the guidelines seem to suggest?