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D M Nathan

Publications and source records attributed to D M Nathan.

94 records · Page 6Linked to original sources

Diets for insulin pump and multiple daily injection therapy.

The role of diet in achieving and maintaining normalized blood glucose control in type I diabetic patients using insulin pumps or multiple daily injection (MDI) regimens is not well defined. We describe herein dietary guidelines that have proved effective in the management of such patients over 3 yr. The guidelines stress the importance of a careful dietary history, the regularity and consistency of diet during the preliminary adjustment period, the establishment of a variable insulin dosage schedule based on meal size and content as well as blood glucose, the appropriate treatment for hypoglycemia, and dietary adjustments for exercise. While insulin pump and MDI therapy may ultimately provide increased flexibility in certain aspects of dietary therapy, the diet must be carefully controlled if these innovative modes of insulin delivery are to succeed.

Blood Glucose↗

The importance of intensive supervision in determining the efficacy of insulin pump therapy.

The role of intensive supervision in the success of insulin pump programs was examined in six type I diabetic subjects utilizing a crossover protocol. The highly motivated volunteers who had attained euglycemia during intensive supervision had a significant increase in plasma glucose and hemoglobin A1c concentrations during the period when supervision by the medical team and frequency of self blood glucose monitoring decreased. Intensive supervision is a critical feature in ensuring maximal efficacy of insulin pump therapy. The importance of such supervision may be even greater in less motivated and adherent patients.

Blood Glucose↗

The preparation of an acceptable placebo for NPH insulin.

A suitable placebo for NPH insulin has not previously been available for clinical investigation. A series of organic and inorganic compounds were formulated as insulin placebos and analyzed according to the following criteria: (1) degree of visual similarity to insulin, (2) stability, (3) absence of local side effects, and (4) clinical safety. Dilute suspensions of cortisone acetate (1.25-2.5 mg/ml) were found to fulfill the criteria as acceptable insulin placebos. Placebo-controlled studies with NPH insulin can now be performed.

Clinical Trials as Topic↗