Contraindications For Initiation or Ongoing Treatment with Continuous Subcutaneous Insulin Infusion

Treatment by pump can be dangerous because of the risk of rapid development of ketoacidosis if the infusion is stopped. Therefore, it is contraindicated in patients who do not monitor themselves with regular home blood glucose monitoring, or who are not capable of troubleshooting insulin pump problems.

The following are absolute contraindications to pump therapy:

• Patients who are poorly committed to pump therapy.
• Patients with a pattern of nonadherence to the recommendations of the managing centre.
• Patients on CSII, who over a period of six months to a year, fail to achieve or maintain improved blood sugar control (improved HbA_1c and/or a reduction in hypoglycaemia) when this was the primary indication for initiation of CSII therapy.
• At present, there is insufficient evidence to recommend CSII for patients with type 2 diabetes.