PHILIP FELIG, M. D.; MICHAEL BERGMAN, M.D.
The therapy for insulin-dependent diabetes has been changing in the last 3 years with the increasing application of intensive ambulatory treatment programs involving self-monitoring of blood glucose levels by the patient. Insulin is administered either as multiple manual daily injections or as a continuous subcutaneous infusion delivered by a portable pump. We discuss the implementation, efficacy, complications (including recent reports of deaths in pump-treated patients), and cost of such programs. The potential effectiveness in preventing the long-term complications of diabetes warrants offering a program of self-monitoring of blood glucose levels combined with multiple manual daily insulin injections as a routine treatment option to virtually all patients with insulin-dependent diabetes. Additional observations on safety and efficacy are needed before insulin pump treatment can be considered a routine option. Furthermore, whether intensive treatment involving either manual or pump administration of insulin alters the risk of hypoglycemia as compared with conventional management remains to be established.
FELIG P, BERGMAN M. Intensive Ambulatory Treatment of Insulin-Dependent Diabetes. Ann Intern Med. 1982;97:225–230. doi: 10.7326/0003-4819-97-2-225
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Published: Ann Intern Med. 1982;97(2):225-230.
Cardiology, Coronary Risk Factors, Diabetes, Endocrine and Metabolism.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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