[Intensive insulin therapy in adolescents with type 1 diabetes mellitus: initial experiences with a semiautomatic insulin injection device (the insulin pen)].
Recently new pen-like technical devices (Insulin-Pen) for the administration of insulin have become available. With the new device, short acting insulin is injected before meals and, in addition, a long acting insulin before bedtime (basis-bolus insulin regime). A group of 19 adolescents with type I diabetes mellitus (7 girls, 12 boys, age 12-18 years) have been trained during a short hospital stay (4-5 days with intensive teaching) in the new insulin regime. Experience, now amounting to 131 patients-months, has been favourable without exception. Acceptance is good, and none of the adolescents would prefer to go back to the conventional insulin regime with two injections. Regained flexibility with the amount and timing of meals, and the possibility of reducing the number of meals, have been mentioned as the principal advantages of the new system. The intensified self-monitoring of blood glucose usually was the most cited disadvantage. However, several adolescents felt more assured in daily life with a knowledge of blood glucose levels. Compliance in the management of diabetes during puberty increased markedly; as a result, longterm metabolic control improved significantly. The glycosylated hemoglobin A1 was 9.9 +/- 0.8% before and 7.7 +/- 0.5% (normal less than 8%) with the new insulin regime (p less than 0.001). It is concluded that the use of new pen-like insulin injectors helps to improve metabolic control as well as life quality in insulin-dependent adolescent diabetics. However, of equal importance is instruction by the diabetologist with respect to new possibilities and limitations, particularly the new rules of diet.
Schönle
E J
EJ
Universitäts-Kinderklinik Zürich.
D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D003927:Diet, Diabetic; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000008:administration & dosage*; D008297:Male; D010349:Patient Compliance; D011788:Quality of Life; D013594:Syringes
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin
Intensivierte Insulin-Therapie bei Adoleszenten mit Diabetes mellitus Typ I: Erste Erfahrungen mit dem halbautomatischen Insulin-Injektionsgerät (Insulin-Pen).