Ganz K, Theintz G, Gerber P, Assal J P
Schweiz Rundsch Med Prax. 1990 Oct 9;79(41):1228-9.
To the best of our knowledge, a good glycaemic control must be advised to avoid or delay the degenerative complications of diabetes, bearing in mind an increased risk of hypoglycaemias. Among other techniques, a treatment consisting of multiple injections (basal-bolus concept) is one way to achieve a good control. Although this form of treatment is rather restrictive (frequent blood glucose determinations), the use of pens makes it more acceptable. A fully informed and cooperative patient is a prerequisite before considering this particular type of insulin therapy which, however, is usually not very helpful for older diabetics. It is a misconception to think that every patient receiving insulin should do so with a pen, just as it is incorrect to recommend multiple injections for all type I diabetics. Whether such a therapeutic strategy is indicated should be established for each patient individually. In addition, the fashion for pens should not distract us from all the other problems associated with inadequate diabetic control, such as foot care and systematic blood pressure measurements.
据我们所知,必须建议进行良好的血糖控制以避免或延缓糖尿病的退行性并发症,同时要牢记低血糖风险增加。在其他技术中,多次注射治疗(基础-餐时概念)是实现良好控制的一种方法。尽管这种治疗方式有一定限制(需频繁测定血糖),但使用胰岛素笔使其更易被接受。在考虑这种特殊类型的胰岛素治疗之前,充分知情且配合的患者是前提条件,然而,这种治疗通常对老年糖尿病患者帮助不大。认为每个接受胰岛素治疗的患者都应该使用胰岛素笔是一种误解,正如为所有1型糖尿病患者推荐多次注射也是不正确的。是否采用这种治疗策略应针对每个患者单独确定。此外,胰岛素笔的流行不应使我们忽视与糖尿病控制不佳相关的所有其他问题,如足部护理和定期测量血压。