The value of good control View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

1979-09

AUTHORS

J. C. Pickup, H. Keen

ABSTRACT

There is still little agreement about the meaning of diabetic control and how to attain and maintain degrees of control close to the non-diabetic state. Variations in blood glucose within the day, measures of unpredictability (“brittleness”) from day to day and glycosylated haemoglobin assay contribute to our understanding of glycaemic control. However, criculating concentrations of many other intermediary metabolites and hormones are disordered in diabetes and should also be taken into account.The best conventional insulin regime which is readily acceptable to the patient is probably a mixture of short and intermediate acting insulin given twice daily, with self-monitoring of blood glucose and adjustment of dose according to values obtained.Continuous subcutaneous insulin infusion (CSII) with a dual rate, portable syringe pump, is a new, still experimental, approach to achieving long term metabolic near-normalisation in insulin-dependent diabetics. In long standing diabetics with increased microalbuminuria, strict control for just a few days reduced or normalised urinary albumin excretion. Some preliminary results in diabetics with severe retinopathy showed encouraging response to several months of good control by CSII. Furthermore, long periods of good control may improve remaining β-cell function in newlydiagnosed insulin-dependent diabetics. A high priority must, therefore, be given to prospective trials testing the effects of metabolic near-normalisation on the evolution of diabetic tissue complications and, in particular, microangiopathy. More... »

PAGES

54

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/bf02938140

DOI

http://dx.doi.org/10.1007/bf02938140

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1023073301

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/521250


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