Abstract Body: Until recently, smart insulin pumps were popular only among type 1 diabetes subjects. With increasing longevity, more type 2 diabetes subjects require insulin to sustain life. Pumps are gaining popularity as an advanced insulin delivery device, offering flexibility in life styles & improvement in QoL.

     Usual initial pump training is on basic functions like basal, bolus & suspend. Advanced functions like insulin sensitivity factor, insulin carb ratio, bolus wizard, temporary basal & dual/square wave bolus are taught only after 1-2 months after pump usage, when they are more comfortable and less confused.

     Analysis of our data revealed differences in results after receiving same advanced training- with one group (A), n=8, using new knowledge judiciously and intelligently whereas the second group (B), n=8, misusing it for eating and pumping more.

     Average baseline A1c in both groups was 7.5%; six months after advanced training, 'A' had mean A1c 6.8% and 'B' had 7.6%. In 'A', weight reduction was around 5.5% (p<0.0001, CI 1.6) compared to 'B' with a weight gain of 3.0% (p=0.12) from the baseline. 'A' had a reduction in total daily dose of insulin (TDD) by 6-8 IU compared to increase in 'B' by 8-10 IU.

     In summary, 'A' had significant weight reduction, reduction in TDD, and reduction in HbA1c compared to 'B'. 'A' had followed the instructions on diet, exercise, telemedicine follow up and along with it utilised the extra pump functions judiciously for sustaining life("Pumps for Life") whereas B exploited the features like bolus wizard, temporary basal, extended bolus etc for extra doses of insulin in accordance with food intake ("Pumps for Luxury"). We highly recommend identifying patient characteristics and modulating the pump training sessions accordingly with help of dietician, diabetic educator, psychologist etc., customizing their sessions to meet individual challenges so as to prevent inadvertent misuse of an advanced gadget for insulin infusion.

Insulin pumps are successful in the long run in T2 diabetes only when the extra functions in the advanced gadget is used properly for life and not for luxury