Comprehensive diabetes treatment has been shown to reduce quality of life in diabetic patients. However, there is evidence to suggest that group singing can have positive effects on quality of life in various clinical settings. In this randomized controlled pilot study, the effect of singing as a therapy to reduce stress and improve quality of life was investigated in insulin-dependent diabetic patients, undergoing a lifestyle intervention program. Patients from the singing group felt less discontented following treatment. This effect, however, was lost after 3 months. No effect on serum cortisol and plasma adrenocorticotropic hormone (ACTH) levels could be seen when comparing the singing group with the control group, although reduced levels of ACTH and cortisol 3 days after treatment could be found and were still present after 3 months within the group of patients who undertook singing as a therapy. Singing led to an increase in bodyweight, which interestingly had no effect on glucose control or methylglyoxal levels. Therefore, singing during a lifestyle intervention program for insulin-dependent diabetic patients had a short lasting and weak effect on patients' mood without affecting glucose control, but no significant effect on stress related hormones.

The correct insulin application is an important aspect of a successful insulin therapy. Today, we have devices, which make insulin therapies easier to handle, socially more acceptable, and safer Of these, insulin pens are the most frequently used devices. This paper summarizes the particular knowledge necessary for correct and precise instruction of patients with regard to the choice of the pen and the fitting syringe as well as details of the correct use of the different pens. The injection technique itself does not differ from the one with syringes and needles. Nevertheless, some important aspects are pointed out.