INS and type 1 diabetes mellitus: The few studies reporting both costs and insulin pump usage showed marked differences in the proportion of T1DM patients using insulin pumps, ranging from 1.2% in Brazil (2008 to 2010) [14], 18% in California (July 1st 2009 to June 30th 2012) [13] to more than 25% in Germany 2007 [8] and 37% in the Netherlands (unpublished data).