New ways in treatment on insulin-dependent diabetes

In our work we have tried to show that the only appropriate method of treatment for a type I diabetic is that which helps to maintain a near-normal compensation, which does not bother the patient and allows him a flexible way of life, and for which there is a sufficient technical equipment including the possibility of blood glucose monitoring. We have found out that all modes of insulin administration are effective, all can achieve a good compensation. Where the both conventional methods (basal-bolus regimen, multiple doses regimen) fail, we use the continuous subcutaneous insulin infusion (CSII). But we warn of undue optimism, and we recommend to use the CSII treatment only during hospitalization, when an exact blood glucose monitoring can be secured. An out-patient CSII treatment is--according to our experience--possible only when a consiliary supervision or a phone consultation of the patient with the attending team can be provided round the clock. We recommend therefore to use CSII routinely as a method of treatment only when the following preconditions are fulfilled an exact indication, education and motivation, technical equipment, and therapeutic supervision in outpatient treatment.