# Introduction he conception of administer continuous insulin appeared in the United States in early 1960s. Dr Arnold Kadish was the first individual who intended the primary closed-loop insulin pump tool that functioned by administration of continuous insulin to the patient accompanied with automatic blood glucose detecting. Practically this device was unsuitable because of its oversize. [ Patients demanding extraordinary insulin dose. # Pregnancy complicated with diabetes It is probable that approximately 375,000US patients use the insulin pump, with this figure likely to increase.[9] It has been used for more than 35 years. [10] The FDA permitted Medtronic's MiniMed 530G with Enlite in 2013, under its novel Artificial Pancreas Device System-Threshold Suspend guidelines, as the earliest device that adjust insulin release in reaction to CGM sensor data. [11] Threshold suspend means that when CGM sensor glucose levels decline below a specified threshold, the pump warnings and hangs insulin delivery for 2 hours. The usage of this device has been revealed to lessen nocturnal hypoglycaemia. [12] Author: e-mail: ismat4me@sudamedica.com Exact Features of Patients Who Are Not Suitable Candidates for Insulin Pump Use: [13] Reluctant to implement MDI doses 3-4 daily, regular SMBG more than 4 daily and carbohydrate counting Absence of inspiration to accomplish close-fitting glucose control History of psychiatric disorders (e.g., psychosis, severe anxiety, or depression) Significant doubts about pump usage affecting lifestyle (e.g., contact sports or sexual activity) Impracticable hopes of pump therapy (e.g., faith that it reduces the need to be in charge for diabetes controlling) T 7 Year 2021 # Global Journal of Indication of CSII for paediatric diabetic patients issued in 2006 in Berlin on conference attended by specialists in paediatrics diabetes: [14] ? Raised HbA1c levels on injection remedy ? Recurrent, severe hypoglycaemia ? Usually unsettled glucose levels ? A management schedule that compromises lifestyle ? Microvascular and macrovascular complications Perfect nominees for paediatrics CSII include patients with interested relatives who are dedicated to observing blood glucose minimum 4 times per day and know show estimate bolus insulin doses. # a) Insulin Pump Treatment for diabetes during Pregnancy Due to the fact that pregnancy is a state where hastened level of ketone bodies in the women. [15] Minimum hours of insulin intermission can cause hyperglycaemia and ketosis. High ketone bodies during pregnancy lead to fetal death. [16] There is no long acting insulin in the pump infusion, there for to be safe side a little dose of neutral protamine Hagedorn(NPH) or insulin detemir may be administered at night to guarantee that there will never be a deficiency of insulin in circulation if the needle get out.13 # Advantages and Disadvantages of Insulin Pump Therapy: [17][18][19][20] # Advantages Disadvantages Improve # Conclusion In diabetic patient, the ideal way to administer insulin is in away mimic pancreas releases it. The perfect method to administer it in that way is insulin pump more than any other methods.[23] Nowadays the growing acceptance of insulin pump treatment has positioned more responsibility on medical experts and nonmedical personnel who do not have diabetes speciality, like accident and emergency department, hospital staff and school teachers. This revolution necessitates that these specialist strain themselves with this form of insulin supply. [24] Recently insulin pumps manufactures shows moreimprovement. It became less in size and more practicalfor usage. The American Diabetes Association identifythat CSII is as unhurt as multiple injection therapy, whensuggested measures are monitored.[5] Insulin Pumpsare undersized electronic devices which provide insulinby two approaches:[6]Basal Insulin, which is constant & continuouscalculated dosage.Bolus Insulin, which is a mealtime dose.Common indications and contraindications forinsulin pump treatment in diabetic individuals:[7][8]IndicationsContraindicationsRepeated events of sever hypoglycaemia withDiabetes with psychiatric disordersmultiple daily injectionsPatient failure to hits HbA1c goal inspite of MDIReluctance to self-monitor of blood sugarand HbA1c remains ? 8.5%.Individual with diabetic complications such asshortage of time and motivation to maintainneuropathy, nephropathylycaemic controlPatient with considerable dawn phenomenonCannot be proficient on crucial practical part ofinsulin pump treatmentDiabetes individual looking for improved quality oflife. © 2021 Global Journals * Continuous subcutaneous insulin infusion (CSII) 30 years later: still the best option for insulin therapy DBruttomesso SCosta ABaritussio Diabetes Metab Res Rev 25 2009 * MiniMed 530GFDA Approval Letter U Food and Drug Administration * Threshold-based insulin-pump interruption for reduction of hypoglycemia RMBergenstal DCKlonoff SKGarg NEnglJMed 369 2013 * Use of insulin pump therapy in the pediatric age-group: consensus statement from the European Society for Paediatric Endocrinology, the Laws on Wilkins Pediatric Endocrine Society, and the International Society for Pediatric and Adolescent Diabetes, endors. Diabetes Care MPhillip TBattelino HRodriguez TDanne FKaufman 30 Internet]. 2007Jun1[cited2015Aug5 * Accelerated starvation in late pregnancy: a comparison between obese women with and without gestational diabetes mellitus TABuchanan BEMetzger FreinkeLn AmJObstetGynecol 162 1990 * Effect of euglycemia on the outcome of pregnancy in insulindependent diabetic women as compared with normal control subjects LJovanovic MDruzin CMPeterson Am J Med 71 1981 * The Living Textbook of Diabetes CSII: benefits and drawbacks-Management-Diapedia 2015 Jul 15 Internet * Management of type1 diabetes mellitus in children and adolescents 2015 Jul 14 Internet * Continuous subcutaneous insulin infusion for the treatment of diabetes mellitus|Guidance and guidelines|NICE.NICE * Model of care document 2015 cited * Pumping Protocol: A Guide to Insulin Pump Initiation BWBode JKyllo FRKaufman Medical Education Academia 2013 * A Primary Care Approach to Continuous Subcutaneous Insulin Infusion 2015 Internet. cited * Basics of Insulin Pump Therapy Jul29 * Guidelines for application of continuous subcutaneous insulin infusion(insulin pump) therapy in the perioperative period MEBoyle KMSeifert KABeer JDiabetesSciTechnol 6 2012