We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Pump and Brittle Circumstance

Samuel Vaisrub, MD
JAMA. 1980;243(22):2331-2332. doi:10.1001/jama.1980.03300480051030.
Text Size: A A A
Published online


When told that someone we know is equipped with an electronic device, we might guess this to be a Holter monitor, a cardiac pacemaker, a sophisticated hearing aid, a carotid sinus inhibitor, an electrical nerve stimulator for intractable pain, or a respiratory trigger for phrenic nerve paralysis. That the device may be an insulin infusion pump is not likely to enter our minds.

A regulated, continuous insulin infusion pump would respond to an obvious need. Despite many claims to the contrary, insulin-dependent diabetics cannot often, if ever, be properly cared for by diet and conventional depot insulin injections. It is difficult to attain homeostatic balance without feedback information on shifting glycemia in patients who have no appreciable insulin reserve. Homeostasis could be attained only by transplanting a pancreas or grafting pancreatic islets—procedures that would be ideal were it not for scarcity of donors and lifelong problems of immunosuppression.

Less amibitous,


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.