Insulin therapy for patients with type 1 diabetes.
The incidence of type 1 diabetes is increasing world wide, especially in younger children. Unfortunately, there is little information on the incidence of type 1 diabetes or its management from India. Recent studies have emphasized the importance of strict glycemic control in the prevention and delay of chronic microvascular complications of diabetes mellitus. This has lead to increasing efforts in devising means of physiological insulin delivery, in which basal insulin and meal related boluses of insulin are separately given and insulin doses are appropriately altered based on frequent blood glucose testing, meal size and exercise. Newer insulin analogues, which better mimic basal and meal related increments of insulin secretion, have been marketed. Regimes for physiological insulin delivery, such as multiple subcutaneous insulin injections and continuous subcutaneous insulin infusion are becoming increasingly popular. However, the high frequency of hypoglycemia is an important constraint to achieving normal glycemic control. In developing countries such as India, other obstacles include the high cost of insulin and blood glucose monitoring strips, social barriers to accepting insulin injections and lack of trained teams for management of type 1 diabetes.
Bhatia
Eesh
E
Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow.
Aggarwal
Ajay
A
D001786:Blood Glucose / Q000187:drug effects; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D015994:Incidence; D007194:India / Q000453:epidemiology; D007328:Insulin / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*; D000078790:Insulin Secretion
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin