Better cortisol control with a pump?

Adrenal insufficiency can be caused by Addison's Disease, Congenital Adrenal Hyperplasia, (CAH), adrenoleukodystrophy, sudden withdrawal of corticosteroids, adrenal tumors, as well as a number of other disease processes.

People with adrenal insufficiency (AI) must take replacement steroids, usually in the form of hydrocortisone tablets to try and replicate the natural rhythms of cortisol that the body supplies. AI patients need hydrocortisone to maintain blood sugar, blood pressure, energy, and to mount a stress response to illness.

It often occurred to me how great it would be if there was a way to gauge Annie's circadian rhythms, as it related to her natural need for cortisol, and supply it through a subcutaneous pump, much like the pumps diabetics use to release insulin.

Well, Dr. Peter Hindmarsh, an endocrinologist at Great Ormond Street Hospital in the UK, actually does this for his patients, and from the sounds of this article, he does it with good success. He has his patients check in once a year to closely monitor their need for cortisol through the day, and adjusts their dosing schedule/amount based on his findings. This helps his patients get the right dose at the right times, affording them the best quality of life possible.

My question: why don't we have this technology in the US? Or do we? A subcutaneous pump that delivered the optimal dose of hydrocortisone could be life changing for those with adrenal insufficiency.