For years MiniMed (now Medtronic MiniMed) has dominated this market. It seems to be such an attractive market, however, that this industry pioneer must be giving up share not only to arch-rival Disetronic but also to new and forthcoming entrants into the market—Animas, Debiotech, Deltec, Diabetex, SOOIL, and Therafuse. Yet the biggest challenge to Medtronic MiniMed has to be not from a rival pump manufacturer but to a relatively new insulin from Aventis—Lantus. With a flat profile of at least 24 hours in most users, Lantus is the ideal basal insulin. When supplemented by bolus shots before meals, many people are getting the kind of control that they only dreamed of earlier.

Yet people continue to turn to the pump. Some of them are those who have tried Lantus without success, according to Gabrielle Kaplan-Mayer, the author of Insulin Pump Therapy Demystified: an Essential Guide for Everyone Pumping Insulin (New York: Marlowe & Company, 2003, 192 pp., paperback, $15.95).

Gabrielle was diagnosed with diabetes exactly 21 years ago, when she was 10. She has been on the pump since 1999. I don’t know which pump, because she doesn’t say. Part of me wishes she told us what her preferred pump is, while another part understands that she might not have the experience to single out the one she uses at the expense of those she hadn’t had the opportunity to try.

A comparison of the features of the pumps of four of the manufacturers is a useful part of this book. In another 25 or so short chapters Gabrielle covers all the important considerations for those who are thinking about going on one.

Pumps do remain a mystery for many of us with diabetes, making the “demystified” label of this book quite appropriate. As Gabrielle points out, 88 to 90 percent of those of us on insulin are not using a pump. She wonders why and answers her own question. Many of us are satisfied with “good enough.” Some certainly are concerned with the cost, particularly if the lack health insurance. But most probably just need more information.

That information is here. Gabrielle’s book is a major contribution to the growing literature of diabetes by people who know the disease first hand. In fact, I can think of only one other book about insulin pumps by someone who uses one. That is Pumping Insulin: Everything You Need for Success With an Insulin Pump by John Walsh and his wife Ruth Roberts (San Diego, Torrey Pines Press, third edition, 2000, 288 pp, paperback, $23.95). John has been on the pump for 19 years and also writes from his intimate knowledge of the device. Both books deserve close attention from anyone considering the pump.

The URL for the book is http://www.insulinpumpbook.com.