title: Effect of multiple insulin injections with a pen injector on metabolic control and general well-being in insulin-dependent diabetes mellitus.
abstract: The long-term (1) effect of multiple insulin injections in clinical practice was evaluated prospectively in 168 unselected consecutive insulin-dependent diabetic patients, age 31 (10-77) yr, attending a diabetic clinic. All patients received three or more daily injections of short acting insulin using a pen injector (NovoPen) plus one injection of intermediate acting insulin at bedtime. Haemoglobin A1c remained nearly unchanged, baseline: 8.6 (5.7-11.8)%, and after intensified treatment for 12 months: 8.3 (5.7-12.3)%. The frequency of keto-acidosis (0.08 (conventional treatment) versus 0.02 episodes/patient/yr, p less than 0.05) and severe hypoglycaemia (0.69 (conventional treatment) versus 0.38 episodes/patient/yr, p less than 0.005) diminished during intensified treatment. Ninety percent of the patients reported improvement in general well-being and only three percent felt worse. We conclude that multiple insulin injections with a pen injector applied in clinical practice improves general well-being, diminishes the risk of acute metabolic complications, while the overall metabolic control as reflected by haemoglobin A1c remains unaltered.
authors.affiliation: Hvidöre Hospital, Klampenborg, Denmark.
authors.forename: M A
authors.initials: MA
authors.lastname: Gall
authors.forename: E R
authors.initials: ER
authors.lastname: Mathiesen
authors.forename: P
authors.initials: P
authors.lastname: Skøtt
authors.forename: L
authors.initials: L
authors.lastname: Musaeus
authors.forename: S
authors.initials: S
authors.lastname: Damm
authors.forename: H
authors.initials: H
authors.lastname: Beck-Nielsen
authors.forename: H H
authors.initials: HH
authors.lastname: Parving
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy* / Q000523:psychology; D016883:Diabetic Ketoacidosis / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control; D007003:Hypoglycemia / Q000517:prevention & control; D007279:Injections, Subcutaneous / Q000295:instrumentation / Q000379:methods; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male
chemical_list: D006442:Glycated Hemoglobin; D007328:Insulin