The importance of intensive supervision in determining the efficacy of insulin pump therapy.

The role of intensive supervision in the success of insulin pump programs was examined in six type I diabetic subjects utilizing a crossover protocol. The highly motivated volunteers who had attained euglycemia during intensive supervision had a significant increase in plasma glucose and hemoglobin A1c concentrations during the period when supervision by the medical team and frequency of self blood glucose monitoring decreased. Intensive supervision is a critical feature in ensuring maximal efficacy of insulin pump therapy. The importance of such supervision may be even greater in less motivated and adherent patients.