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I have been an endocrinologist involved in the management of diabetes for the past 45 years. I told one of my patients this week that nothing that I do now to manage diabetes was learned in medical school or training. Technology and knowledge have progressed at a rapid pace and have made diabetes management vastly better and easier for patient and clinician.

We have new medications and more rapid-acting insulins, but mostly, we have reliable continuous glucose monitors, and these are now integrated into hybrid closed-loop insulin pumps.

This last improvement, which has occurred since the last edition of this book was published, is a game changer. This has changed the paradigm of glucose management from A1C to time in range, reducing time in hyper- and hypoglycemia. With these innovations, starting patients on pumps provides even more benefits.

Despite all of these improvements in technology, selecting patients for and starting patients on pumps still require a great deal of education, training, time, and knowledge on the part of the healthcare provider.

I have known Karen Bolderman since she began working for me as a diabetes educator 40 years ago. After several years in industry, Karen and I worked together again at the Geckle Diabetes and Nutrition Center at Greater Baltimore Medical Center and then briefly when we migrated to Florida. Now we live just a few houses apart. I look forward to continued partnership with Karen in our attempts to improve diabetes care.

I have known Dr. Argento since his days as a resident at the Veterans Affairs Medical Center in Baltimore where I was junior faculty. Then for 30 years, we each ran endocrine practices in the Baltimore–Washington, DC area. We did not compete much for patients, but we did compete in recruiting new endocrinologists for our practices. Our approach to diabetes management has always been largely in sync, and his expertise in pump therapy is unmatched in the clinical sphere.

Karen and Nick have done a marvelous job with the details of insulin pumps in this edition of Putting Your Patients on the Pump. This book will make everyone’s job of training patients and using insulin pumps and continuous glucose monitors more understandable and practicable.

Read ahead and enjoy.

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