Treatment with insulin in form of continued subcutaneous infusions is intended to mimic the normal pancreatic function. Insulin pumps are currently a reality and they allow for an improvement of glycemic oscillations and contribute to decrease HbA1c and to improve patient's quality of life. Infusion systems are quite advanced and the challenge at present are glycemia sensors. There are several trials under way which are trying to establish if it is possible for sensors to work with a closed-loop system. In the meantime, patients will continue to perform (and interpret) glycemic controls. The role of physicians must be to advice patients about diabetes and the management of pumps so that they are able to minimize hypoglycemias and optimize glycemic controls.