The Insulin pump therapy (Continuous Subcutaneous Insulin Infusion, CSII) is a modern form of insulin therapy. A small, portable device continuously delivers insulin under the skin, simulating the natural insulin release of the pancreas much better than classic injection therapy.
How it works
The pump continuously delivers small amounts of fast-acting insulin (basal rate) via a thin catheter. The user can request a bolus (additional dose) at meals or when needed. Modern pumps can be connected to a CGM sensor and work semi-automatically (hybrid closed-loop system).
Advantages over injection therapy
| aspect | advantage |
|---|---|
| Precision | Dosage possible in steps of 0.01 IU |
| Flexibility | Hourly adjustable basal rate (e.g. for dawn phenomenon) |
| Metabolism | Less severe hypoglycemia and more stable blood sugar levels |
| Quality of life | Fewer injections, more freedom when doing sports and traveling |
Indications
Insulin pump therapy is particularly recommended for:
- Unstable blood sugar despite intensive injection therapy
- Frequent or severe hypoglycemia
- Hypoglycemia unawareness disorder
- Pregnancy with diabetes
- Children and adolescents with diabetes
- Strongly changing daily routine (shift work, athletes)
Risks and disadvantages
- Higher risk of ketoacidosis with pump failure or catheter problems
- Changing the infusion set regularly (every 2-3 days)
- Possible infections at the injection site
- Technical dependency and higher costs
Further information:
→ Diabetes mellitus – knowledge and overview
→ Why hyporest
→ Autonomic neuropathy
Sources
- German Diabetes Society (DDG). S3 guideline “Insulin pump therapy”. As of 2025. Available at: www.deutsche-diabetes-gesellschaft.de/leitlinien.
- American Diabetes Association. Standards of Medical Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1). Available at: diabetesjournals.org.
- Robert Koch Institute (RKI). Federal health reporting – diabetes mellitus in Germany. Berlin 2024.
- International Diabetes Federation (IDF). IDF Diabetes Atlas. 11th edition. Brussels 2025. Available at: diabetesatlas.org.
Important note:
The information in this encyclopedia article is intended solely for general and non-binding information. They do not replace medical advice, diagnosis or therapy. If you have any health questions or complaints, please always consult a doctor or qualified healthcare professional. The content was created with the greatest possible care, but errors cannot be completely ruled out.
Last updated: February 26, 2026
