The astonishing power of insulin to restore health and wellbeing
to rapidly deteriorating newly diagnosed Type 1 diabetic
patients is as remarkable now as it was in 1922.
After Banting gave insulin to Elizabeth Hughes in that year, she wrote to her
mother that “it is simply too wonderful for words this stuff.”
Insulin to this day always has this effect; the challenge now is to
optimise control in order to maintain health throughout life.
Insulin is also needed to enhance well-being and control in
many Type 2 diabetic patients when the natural progression of
their disease has lead to loss of optimal control.
The potential to reduce the development of long-term diabetic complications
as demonstrated by the UKPDS (see page 42) has led to a
recent explosion in conversions from tablets to insulin.
The difficult decisions which surround the need for insulin in this
situation, together with benefits, uses and misuses of insulin
have been described in the previous chapter.
The use of insulin must be tailored to meet individual
requirements.
The aim is to achieve the best possible control in
the circumstances, avoiding at all costs the disabling
hypoglycaemia which can occur if control is excessively tight.
In some elderly patients and those who lack motivation, it is
therefore wise to aim only at alleviating symptoms and not to
No comments:
Post a Comment