Virtually all major pharmaceutical companies have deployedfield-based medical support programs. Since 1967, medical liaison personnel have supported a range of customers, including opinion leaders, investigators, and health care decision makers. This article summarizes the history of field-based medical programs, and provides results of a 1999 pharmaceutical industry medical informution survey and information on establishing a regional liaison program. Technological advances, consolidation of decision making, and the increasing complexity of health care decisions will mandate the need for continued field medical program development and expansion.

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Self-regulation of diabetes depends in part on common-sense models of symptoms and blood glucose fluctuations. Symptom perception and subjective estimation of blood glucose were studied in 52 adult, difficult-to-control, non-insulin-dependent diabetics using a structured interview and laboratory blood-glucose measurement. Most patients believed they could detect hyperglycemia. Symptoms linked by patients to hyperglycemic and hypoglycemic episodes did overlap with symptoms traditionally associated with those states. Some patients may experience dysphoria during glycemic swings to which multiple symptom labels are applicable, although prominent exceptions and idiosyncratic symptoms were evident. Estimation of current blood glucose using an ordinal scale suggested some capacity for discriminating blood glucose levels. Numerical estimates of Chemstrip values were correlated with actual values, but far too inaccurately for purposes of self-regulation. Research is needed to clarify whether subjective symptom perception and blood glucose estimation helps or hinders self-regulation of diabetes.

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