title: Outpatient self-management of severe diabetes.
abstract: We initiated a five-point program to decrease acute and chronic complications in 25 unstable, insulin-dependent diabetics (study group A). The five points were home monitoring of blood glucose, use of multiple injections of a complex insulin mixture, strict dietary control with high protein feedings, carbohydrate loading before exercise, and use of purified insulin preparations. There was an 80% decline in detected hypoglycemic reactions over the succeeding six months. The hospitalization rate fell from 3.4 times per year to 0.64 times a year. An additional five extremely unstable diabetic patients (study group B) were treated with the same program except for the use of an open-loop continuous infusion system for insulin. Although results in this group were favorable in terms of improving glucose homeostasis, mechanical, physical, and psychologic problems can limit usefulness current devices.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D006801:Humans; D007267:Injections; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D007332:Insulin Infusion Systems; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D012648:Self Care
chemical_list: D001786:Blood Glucose; D007328:Insulin