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Good long-term quality of life without diabetic complications with 20 years of continuous subcutaneous insulin infusion therapy in a brittle diabetic elderly patient.

More than 20 years have passed since continuous subcutaneous insulin infusion (CSII) was proposed as a means of controlling glycemia in insulin-dependent diabetes by Pickup et al. (1). Since that time, the American Diabetes Association has approved CSII as an effective means of implementing intensive diabetes management, with the goal of achieving near normal levels of blood glucose and improved lifestyle flexibility (2). Although the effect of long-term control with CSII with regard to complications has been studied (3–5), the duration of these studies does not exceed 20 years. After 20 years of diabetes, nearly all patients with type 1 diabetes and 60% of patients with type 2 diabetes have some degree of retinopathy (6), and most have other diabetic complications, including macrovascular disease (7).

We hereby report a patient with brittle diabetes with good long-term quality of life without any diabetic complications who was treated by CSII for 20 years (8,9). The patient is a 72-year-old woman (height 147 cm, weight 45.5 kg, and BMI 21 kg/m2). Her blood pressure was …