To the Editor.
—Dr Saudek and colleagues1 claim that implantable insulin pumps improved aspects of quality of life in their study of patients with non-insulin-dependent diabetes mellitus (NIDDM), although this treatment was associated with a considerable rate of adverse events as compared with subcutaneous injections. However, the Diabetes Control and Complications Trial (DCCT) quality-of-life questionnaire2 that was used by the authors appears to be the wrong instrument for studying older patients with NIDDM receiving implantable insulin pump therapy. The DCCT questionnaire originally had been designed for younger patients with insulindependent diabetes mellitus (IDDM) receiving subcutaneous insulin therapy,2 with no reference to the particular conditions of the implantable insulin pump. Hence, the better scoring of Saudek's patients with NIDDM receiving the implantable insulin pump on the "impact of disease" subscale could be an artifact. Despite the claims of Saudek et al, objective and subjective benefits of the implantable insulin pump for
Chantelau E. Treatment of Patients With Non-insulin-dependent Diabetes With the Implantable Insulin Pump. JAMA. 1997;277(7):529. doi:10.1001/jama.1997.03540310027018