Intensive insulin therapy in clinical practice

A randomized controlled trial of Sweet Talk, a text‐messaging system to support young people with diabetes

“…While conventional behavioural support interventions have been shown to effect the uptake of IIT, they frequently do not attract young people [10,11], require significant resources and patient commitment, and are not incorporated routinely into clinical practice [12]. There is therefore a need to find ways of supporting, educating and motivating young people with Type 1 DM [13]. The challenge is to develop validated, innovative support systems that appeal to young people, encourage uptake of IIT, and which are practical and feasible to deliver within existing health resources.…”

Insulin Binding to Antibodies is a Risk Factor for Inexplicable Severe Hypoglycaemia in Children with Type-1 Diabetes Mellitus

“…Hence, patients with a severe, inexplicable hypoglycaemia and an insulin binding capacity >15 % may be advised to switch from intensive (basal-bolus-)insulin therapy with more than 3 injections per day and a variable meal schedule (insulin dose adaptation for normal eating DAFNE ( DAFNE Study Group, 2002 )) to conventional insulin therapy with two injections of intermediate acting insulin per day (and a meal schedule with regular main meals and snacks). As has been shown repeatedly, conventional insulin therapy (together with self-monitoring) can be as satisfactory as intensive (basal-bolus) insulin therapy in terms of metabolic control ( Home, 1997 ;Scheepker et al, 2007 ;de Beaufort et al, 2007 ). Moreover, it will also improve quality of life by reducing fear of severe hypoglycaemia ( Cryer, 2002 ).…”

Diabetes Mellitus and Closed-Loop Insulin Delivery

“…Intensive treatment involves a programme of extra blood glucose testing and smaller, more frequent insulin injections. There is a practical limit to this in terms of the acceptable frequency of daily invasive events, although some reports mention up to eight injections of soluble insulin daily (Home, 1997). It must also be important to recognize the psychological effects of such introspection.…”