Background: The aim of this study was to evaluate the long-term effects of continuous subcutaneous insulin infusion (CSII) therapy on the improvement of metabolic control and beta-cell function in patients with type 2 diabetes mellitus.

Methods: A single-center retrospective observational study was carried out in patients with T2DM who required CSII therapy due to suboptimal glycemic control. T2DM patients treated with the DANA-R Diabecare insulin pump (SOOIL Development Co., Ltd.) were followed for 6 years. Glucose control measures (hemoglobin A1c, total daily insulin dose) and beta-cell function (c-peptide index, insulinogenic index) were analyzed and clinical outcome data (body mass index, systolic/diastolic blood pressure, hemoglobin, serum protein, serum albumin, serum creatinine, total cholesterol, triglyceride, HDL, and LDL) were assessed after 2, 4, and 6 years use of CSII. Statistical significance was calculated by Student’s paired t-test.

Results: Fifty-seven T2DM patients with a mean age of 58.2±1.1 years were included in the study with 6 years (75.1±5.0 months) of follow-up. We found a statistically significant improvement in glycated hemoglobin (7.7±0.2, 6.3±0.1, 6.3±0.1, and 6.5±0.1%, p<0.0001), total daily insulin dose (48.6±3.1, 39.7±2.9, 34.2±2.0, and 34.4±2.2 U/day, p<0.0001), c-peptidogenic index (0.28±0.03. 0.42±0.07, 0.32±0.04, and 0.38±0.07, p<0.05), and insulinogenic index (3.28±0.53, 8.62±1.09, 6.47±0.74, and 5.84±0.96, p<0.001) after 2, 4, and 6 years use of CSII, respectively. Additionally, there were differences in clinical outcomes such as serum protein, albumin, total cholesterol, triacylglycerol, HDL, and LDL after 6 years.

Conclusions: The use of long-term CSII therapy for patients with T2DM led to a statistically significant and sustained improvement in glycemic control and beta-cell function.

Soo Bong Choi, M.D., Ph.D., is an Emeritus Professor of Internal Medicine at Konkuk University Medical School and Director of the Diabetes Center at Konkuk University Medical Center. He earned his M.D. and Ph.D. from Seoul National University and served as a Visiting Professor at the University of Minnesota and the University of Texas Health Science Center at San Antonio. A world-renowned pioneer in diabetes care, Dr. Choi has dedicated over four decades to advancing Continuous Subcutaneous Insulin Infusion (CSII) or insulin pump therapy. His extensive research demonstrates that long-term CSII significantly restores pancreatic β-cell function, improves insulin sensitivity, and promotes long-term glycemic remission in patients with type 2 diabetes. Choi has authored over 100 international presentations at prestigious conferences, including the ADA and EASD, alongside publishing numerous papers in high-impact journals such as Diabetes/Metabolism Research and Reviews and Diabetes Care. He currently serves as President of the World Association of Diabetes Insulin Pump.