Insulin pumps: are services and health equity undermining technological progression?

Abstract The inspiring story of insulin pump development contains numerous hurdles overcome with leaps in technology. Miniaturisation and increased reliability have led to a discrete device that can deliver more physiologic profile than multiple daily injections. Accumulating evidence supports not only glycaemic benefits lower HbA 1c , reduced glucose variability hypoglycaemia rates but also improved quality life an association reduction mortality. Understandably, patient groups list access technologies as key priority for living well diabetes. Despite this, uptake pumps remains below forecast variation geographically between socioeconomic groups. Criteria from the National Institute Health Care Excellence aim standardise local commissioning; however, major barrier initiating services is sufficient staff numbers appropriate training experience. To aid growth, could be better supported given flexibility deploying their resources. Collaboration centres increasing use virtual platform education clinical support may address equity delivery. There has been proliferation available devices differing advantages limitations; example compatibility software discretion. Sensor augmentation enabled degree automated delivery predicted avoidance; accessibility restricted some highly motivated people type 1 diabetes set up own semi‐automated systems using open source code. Copyright © 2021 John Wiley & Sons.