Continuous Insulin Delivery Systems in the Management of Diabetes Mellitus

The late twentieth century saw innovations in insulin delivery systems, notably the development of ultrafine needles and insulin pens, which replaced traditional vials and syringes. The introduction of multiple daily injection (MDI) regimens and continuous insulin delivery systems, conceptualized by Arnold Kadish, transformed diabetes care. The Biostator, a glucose-controlled insulin infusion system developed by Professor Ernst Pfeiffer, although bulky, introduced the concept of a closed-loop system. The advent of insulin pumps and continuous glucose monitoring (CGM) systems significantly advanced diabetes management. These technologies allow for precise control of insulin delivery, improving glycemic control and reducing hypoglycemia risk. Insulin pumps, particularly hybrid closed-loop systems, provide a combination of automated insulin adjustments and manual bolus delivery for meals and corrections. Modern insulin pumps offer features such as customizable basal rates, bolus calculators, and integration with CGMs, enhancing diabetes management. Insulin pumps, originally intended for type 1 diabetes, are now also used for type 2 diabetes patients, offering flexibility and improved control.