[Insulin therapy: basic principles and strategy].

Abstract

Proper insulin therapy requires close interaction between the patient and his doctor. The still used strategy of conventional insulin treatment employing 1 to 2 insulin injections per day does not suffice to avoid diabetes associated complications. Intensified forms of insulin treatment, however, permit in part "near-normalization" of blood glucose and delay the development of late diabetic complications. Intensified insulin replacement derives its strategy from knowledge about physiological insulin release and requires the patient, and this applies in particular to "Functional Insulin Therapy (FIT)", to measure his blood glucose frequently and to correct aberrant blood glucose values by additional insulin or glucose as necessary. To reach the goal of good metabolic control needs medical guidance of the appropriately trained patient, who, as well as the attending team, requires continuous remotivation to co-operate.