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*Type 2 Diabetes - From Pathophysiology to Modern Management*

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**99**

**Chapter 6**

on Technology

*Alan B. Schorr*

**Abstract**

ments outlined.

**1. Introduction**

Newer Modalities in the Treatment

of Type 2 Diabetes Mellitus: Focus

This chapter will focus on the technological advances for individuals with Type 2 diabetes mellitus and their effect on treatment, control of blood glucoses and possible improvement in lifestyle and decreasing complications. This is a general overview of technological improvements and not an outline for specific patient care. Various technologies will be discussed and the outlook for future improve-

**Keywords:** CSII-continuous subcutaneous insulin infusion, CGM-continuous glucose

During the past 30 years, there has been significant advances in technology for the treatment of patients with Diabetes Mellitus. Most of these advances have focused on patients with Type 1 diabetes mellitus. The perception has been that individuals with Type 2 diabetes mellitus have not needed these advances or that they are not appropriate for a population that does not always require insulin.

Type 2 diabetes mellitus is a disease which is multifactorial: linked to metabolic derangements, Obesity, dietary behavior along with lifestyle issues particularly those individuals who are Sedentary [1, 2]. Given these factors, technology has been considered as adjunct therapeutic modalities to use in addition modification of diet,

Continuous Subcutaneous Insulin Infusion (CSII) has been utilized since the 1970s for the treatment of Diabetes Mellitus. The first insulin pumps were extremely large and bulky. Dr. Arnold Kadish devised a backpack insulin pump in the 1960s, but it proved to be less than optimal for everyday use. Dean Kamen in the late 1970s developed a more practical portable insulin pump which was eventually produced by Baxter called the Auto Syringe. This was the initial insulin pump that this author utilized in the early 1908s. Insulin pumps have evolved significantly over the past 40 years becoming smaller, more precise in the delivery of insulin doses and more reliable than their older versions [3]. During the 1980s to early 2000s,

monitoring, HbA1C, MDI-multiple dose injection, smart pen

education, medications and lifestyle changes.

**2. Insulin pump therapy (CSII)**
