Abstract
The data from the Diabetes Control and Complications Trial show that control of blood glucose with intensive insulin therapy significantly delays complications of diabetes when compared with conventional therapy consisting of one or two insulin injections per day. However, the subcutaneous intensive insulin therapy, including insulin infusion by external pumps, required to achieve the glycemic goals defined by the Diabetes Control and Complications Trial, led to an increased frequency of severe hypoglycemia. Improvements in parenteral insulin therapy are possible by either modifying subcutaneous insulin kinetics (insulin analogs) or developing better routes of administration. Intraperitoneal insulin infusion offers a more physiologic route of insulin delivery. The ultimate goal for the treatment of diabetes remains the development of a fully automated glucose-controlled device.