Treatment of Patients With Non-insulin-dependent Diabetes With the Implantable Insulin Pump

To the Editor. —Dr Saudek and colleagues1begin their article on intensive insulin therapy in individuals with NIDDM with the following sentence: "Intensified insulin therapy can be beneficial in preventing end-organ complications of diabetes, but imposes serious adverse effects of treatment" and conclude with "it is feasible to achieve very good glycemic control in NIDDM using either multiple-dose insulin or implantable insulin pump" therapy. These statements imply that it has been shown that strict glycemic control using frequent doses of insulin reduces the incidence of complications in NIDDM. However, that conclusion is based on results from the DCCT,2which was performed exclusively in patients with IDDM.2 The suggestion that the results of the DCCT may be applicable to NIDDM patients is based on similarities in underlying mechanisms of complications occurring in patients with IDDM and those with NIDDM.3Similar complications in different diseases may be treated using the same