Friday, June 2, 2023
This activity is intended for physicians and nurses.
The goal of this activity is to describe the history of insulin pump technology, review the role of continuous subcutaneous insulin infusion in intensive insulin therapy, and describe the indications for and current experience with CSII.
Upon completion of this activity, participants will be able to:
Medscape, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Medscape designates this educational activity for a maximum of 1 category 1 credit(s) toward the AMA Physician's Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity.
Approved for 1.0 contact hour of continuing education for RNs, LPNs,
LVNs and NPs. This program is cosponsored with Medical Education
Collaborative, Inc. (MEC) and Medscape. MEC is accredited as a provider
of continuing nursing education by the American Nurses Credentialing
Center's Commission on Accreditation.
Provider approved by the California Board of Registered Nursing,
Provider Number CEP 12990, for 1.0 contact hour.
Approved by the Florida Board of Nursing, Provider Number FBN
2773.
For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]
There are no fees for participating in or receiving credit for this
online educational activity. For information on applicability and
acceptance of continuing education credit for this activity, please
consult your professional licensing board.
This activity is designed to be completed within the time
designated on the title page; physicians should claim only those
credits that reflect the time actually spent in the activity. To
successfully earn credit, participants must complete the activity
online during the valid credit period that is noted on the title page.
Follow these steps to earn CME/CE credit:
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Dr. Arnold Kadish of Los Angeles, California, devised the first insulin pump in the early 1960s. It was worn on the back and was roughly the size of a Marine backpack (Figure 1). Rigorous clinical testing for CSII began in the late 1970s,[3-5] and by the early 1980s, CSII was being considered as a possible alternative form of insulin delivery for patients with type 1 diabetes.[6]
Figure 1. The first insulin pump.
The AutoSyringe model, also known as the "Big Blue Brick," was the first commercial pump.[7] Upon its 1978 introduction, excitement spread throughout the medical community, and several companies began to promote the development of insulin pumps. However, many of these pumps lacked the controls necessary to ensure safe insulin delivery. They were not very user-friendly, and some models even required the use of a screwdriver for dosage adjustment.[8] In addition, the idea of wearing a large, heavy pump and being hooked to a machine understandably met with resistance among patients.[7] In the early 1980s, pump therapy was reserved only for the most difficult-to-manage cases, and the results were often unsatisfactory.[8] By the late 1980s, insulin pump therapy was still used in only a minority of patients.
The 1990s brought major advances in the field of medical device technology, which allowed dramatic reductions in the size of the pump, brought enhanced safety, and allowed greater ease of use for patients. Currently, most pumps are about the size of a hand-held pager (Figures 2, 3, 4, 5, and 6) and have features such as programmable memory, multiple basal rates, several bolus options, safety lockout features, and remote control.[1]
Figures 2-6. Today's insulin pumps are the size of a hand-held pager. (Figure 6 courtesy Pauline Devney.)
