Insulin pumps and glucose regulation.

With recent technologic advances there has been a resurgence of interest in implantable insulin infusion devices. A satisfactory closed loop system has been elusive. Open loop systems include the pump, delivery catheter, and patient pump communicator. Several such systems are currently undergoing clinical investigation. Implantable pumps can be placed with minimal morbidity. Insulin underdelivery is the most frequent long-term problem. Several recent studies suggest that implantable pumps can safely and effectively maintain good glucose control. The development of a satisfactory implantable closed loop system will be the next step in this technology.