[Insulin-dependent diabetes: clinical aspects and therapy].
The risk for healthy sibs to develop type I diabetes is 3-5%. HLA Dr 3 und Dr 4 plus islet-cell antibodies predispose for the disease. Polyuria, polydipsia etc. plus a blood sugar greater than 200 mg/dl establish the diagnosis in symptomatic-and an OGT in asymptomatic patients. Initially non-ketoacidotic patients can be effectively treated with an insulin mixture of 1/3 regular + 2/3 NPH in a dose of 1 U/kg bw per day with 2/3 in the morning and 1/3 in the evening. Manifestation and duration of remission (= no glucose excretion, insulin less than 0.5 U/kg/day, measurable C-peptide) are related to initial decompensation. At present no therapy is available to prolong remission. The "tailored" therapy for diabetics of long duration is favoured: individual insulin mixtures of less than 1 U/kg/day in 2 divided doses, with 6 of more meals. Metabolic control should achieve a glucose excretion of less than 5% of the consumed carbohydrates, a 2-h postprandial blood sugar of less than 200 mg/dl (140-200 mg/dl) and a HbAlc-concentration below 8% (= less than + 3 SD).
D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics; D003937:Diagnosis, Differential; D003927:Diet, Diabetic; D004200:Diseases in Twins; D004305:Dose-Response Relationship, Drug; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism; D006680:HLA Antigens / Q000235:genetics; D006801:Humans; D007328:Insulin / Q000627:therapeutic use
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D006680:HLA Antigens; D007328:Insulin
Insulinbedürftiger Diabetes: Klinik und Therapie.