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Abstract Continuous subcutaneous insulin infusion (CSII) using an external pump is widely used for the treatment of type 1 diabetes, but has been less evaluated in type 2 diabetes. This review analyzes the open-label as well as randomized controlled studies performed in type 2 diabetic patients. The efficacy of CSII is compared with multiple daily injections (MDI) in terms of glycaemic control, weight variation, insulin requirements, treatment satisfaction and hypoglycaemic events. CSII may be offered as an alternative treatment to type 2 diabetic patients with poor glycaemic control despite high-dose insulin requirements administered through MDI.