title: [Reduction of severe hypoglycemia by functional insulin therapy of type I diabetes mellitus].
abstract: Life style has to be adapted to insulin regimens in conventionally intensified insulin therapy. Functional insulin therapy (FIT) allows for flexible adjustments to changing insulin requirements. FIT is based on separating the substitution of basal, meal dependent and correction insulin by the patient. The patient has to acquire special knowledge. We here report longitudinal data of 183 patients out of 221 patients who have been educated by FIT outpatient programs in the years 1990 to 1996. The 3 month FIT education program consisted of sixteen hours in total. Five and a half hours were held in a whole day preparation seminar and the other seven hours in evening sessions each of 90 minutes duration. Prior to FIT education patients were treated by intensified conventional insulin therapy. Mean glycosylated hemoglobin prior to FIT education was 7.0% (normal range 3.7-5.6%). After FIT education glycosylated hemoglobin remained unchanged. However, the percentage of patients experiencing severe hypoglycemic episodes (stupor and coma) in a one year course was significantly reduced from 26% prior to FIT education to 14% after FIT education--hypoglycemic coma was reduced from 13% to 7% respectively. Thus, we can report that FIT reduces the risk of severe hypoglycemia. We believe that our data should stimulate the broad supply of FIT education programs available to diabetes patients in Switzerland.
authors.affiliation: Abteilung für Endokrinologie, Diabetologie und Klinische Ernährung, Medizinische Universitätsklinik, Kantonsspital Basel.
authors.forename: K E
authors.initials: KE
authors.lastname: Hegar
authors.forename: H
authors.initials: H
authors.lastname: Schächinger
authors.forename: W
authors.initials: W
authors.lastname: Berger
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D003927:Diet, Diabetic; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000517:prevention & control*; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010353:Patient Education as Topic
chemical_list: D001786:Blood Glucose; D007328:Insulin