Overview
Clinical Meaning
Continuous subcutaneous insulin infusion (CSII) via insulin pump delivers rapid acting insulin analogs to mimic physiologic insulin secretion.
Continuous subcutaneous insulin infusion (CSII) via insulin pump delivers rapid-acting insulin analogs to mimic physiologic insulin secretion. The basal rate provides continuous low-dose insulin to suppress hepatic glucose production between meals and overnight, while patient-programmed bolus doses cover carbohydrate intake and correct hyperglycemia. Modern pumps may integrate with continuous glucose monitors (CGM) in sensor-augmented pump therapy or hybrid closed-loop systems. Pump therapy reduces A1C and glycemic variability compared to multiple daily injections (MDI) but carries unique risks: site failure, pump malfunction, and rapid progression to DKA because no long-acting insulin depot exists. The nurse must manage pump therapy during hospitalization, troubleshoot device issues, and implement sick day protocols.