A new look at patient selection criteria for continuous subcutaneous insulin infusion (CSII)

Continuous subcutaneous insulin infusion (CSII) is an increasingly popular modality for intensive diabetes treatment (IT). Appropriate patient selection is a key component for success with CSII. Current guidelines for patient selection are largely based on consensus or expert opinion. While most published studies have shown a modest but significant improvement in glycemic control when patients are switched to CSII, other studies have shown no benefit. One possible reason for this is patient selection criteria, ifmentioned at all, are significantly different. Any attempt at a comparison of existing studies may be confounded by the lack of patient selection criteria. This not only makes itdifficult to compare studies, but may introduce a bias into the conclusions that are reached. The selection of patients for CSII may depend as much upon the availability of a skilled and motivated team as on the patients themselves.