I. Background 2009.7,1.18: The draft for public comment was drafted in early 2009, and after several expert meetings, the draft for public comment was launched at the annual meeting of the Chinese Physicians Association of Endocrinologists and Metabolists (Qingdao) on July 18, and was revised after extensive consultation. One is the Endocrinology Branch of the Chinese Medical Association, and the other is the Endocrinology and Metabolism Physicians Branch of the Chinese Medical Association. The former is based on advocating academics, while the latter is more from regulating behavior, and in the future, it is hoped that multiple societies will participate together and join hands for the same goal, so that the guidelines will be more standardized and standardized, and more conducive to guiding clinicians. This is the first guideline for insulin pump therapy in the world, which was jointly completed by two academic organizations, referring to foreign experience and summarizing a large amount of domestic clinical practice and literature to standardize and rationalize the use of insulin pump therapy. Firstly, it regulates the practice behavior of physicians, secondly, it provides for the rational use of medical resources and achieves the purpose of improving physicians’ own medical practice. With the development and improvement of product technology. Fully intelligent pump has become possible to achieve more convenient treatment and more freedom of life, and at the same time, the level of knowledge of the user has also put forward higher requirements, these will be another task to continue to revise and update the guidelines. Second, the definition of insulin pump therapy previously the insulin pump was not considered as a treatment method, but only a device; and in fact the purpose of its use is exactly the same as the purpose of insulin therapy. However, if we consider that the use of insulin pumps enables physicians to precisely regulate the dose and timing of insulin administration by simulating the physiological secretion of insulin, this mode of treatment has been qualitatively improved compared to traditional insulin therapy, and therefore the use of insulin pumps is explicitly proposed as a treatment method in the guidelines. Insulin secretion in the physiological state can be roughly divided into two parts according to the relationship with meals: one is the continuous secretion of small amounts of insulin not dependent on meals, i.e. basal insulin secretion, in which insulin is secreted in pulses at intervals of 8-13 min; the other is the secretion of large amounts of insulin caused by the stimulation of hyperglycemia after meals. In short, the insulin pump is controlled by artificial intelligence to simulate basal insulin secretion in the body with adjustable pulsed subcutaneous infusion; at the same time, the pre-meal insulin and infusion mode are set according to the food type and total amount to control post-meal blood glucose. III. Advantages of insulin pump therapy? 1.Smooth blood sugar control and reduce blood sugar fluctuation: Insulin pump can flexibly adjust the pre-meal high dose and basal infusion amount according to the patient’s blood sugar situation, effectively control post-meal hyperglycemia and dawn phenomenon, reduce glycated hemoglobin (HbA1c) level, and smoothly control blood sugar. 2.Less weight gain: Insulin pump can reduce insulin dosage and avoid weight gain caused by excessive dose of insulin. In the case of continuous subcutaneous insulin injection with less dosage, patients in this group gained less weight than multiple subcutaneous insulin injections therapy with higher dosage. 3. Significantly reduce the risk of hypoglycemia: The insulin pump mimics the physiological insulin secretion pattern and reduces the infusion basal infusion volume at night, avoiding the occurrence of nighttime hypoglycemia. At the same time, the amount of insulin used for large doses before meals is also reduced, avoiding the overlapping effect of insulin in the body during multiple injections of treatment methods, thus reducing the occurrence of hypoglycemia. 4, reduce the variation of insulin absorption: multiple subcutaneous injection therapy requires the use of medium- and long-acting insulin preparations, and the absorption rate of such preparations varies greatly in the same body, which can lead to sharp fluctuations in blood sugar. While insulin pumps use short-acting or fast-acting insulin preparations, the absorption is more stable than that of medium- and long-acting insulin; multiple subcutaneous injection treatment is prone to hard nodules at the injection site and local fat atrophy, thus affecting the absorption of insulin. For insulin pump users, the infusion site is basically fixed, which avoids the difference of insulin absorption in different sites, and the insulin dosage is significantly lower during insulin pump injection than that during multiple subcutaneous injections, which facilitates insulin absorption. Compared with some insulin-like substances, insulin pump greatly reduces the variability of insulin, which is reduced to 10%. 5, strengthen the glycemic control in the perioperative period of diabetes : The risk of surgery in diabetic patients is higher than in non-diabetic patients, and the postoperative infection rate is about 10 times higher than in non-diabetic patients, and the mortality rate is 2~3 times higher. Therefore, only by strengthening the glycemic monitoring and treatment of diabetic patients in the perioperative period can surgical complications and mortality be reduced and surgery become safer and more effective.