[Intensified insulin therapy in Type 1 diabetes. Results of a 1-year treatment using the basic-bolus principle in hard-to-control diabetic patients].

Thirty-six adult type 1 diabetics, whose metabolic control was unsatisfactory on conventional insulin treatment or on continuous subcutaneous insulin infusion, were treated for an average of 13 months by the basis-bolus insulin regimen using pen-like insulin injectors. HbAlc-values improved from 8.1% before to 6.7% at the end of the observation period, with the same daily injected amount of insulin (39 +/- 2 IU/d before, 38.7 +/- 2 IU/d after switching to the new regimen). The number of hypoglycemic events did not increase with the new insulin regimen. Acceptability was good. Flexibility as to the timing of meals and easy handling of the device were considered the main advantages of the new system. Some patients were bothered by the need for intensified self-monitoring of blood glucose. The insulin regimen according to the basis-bolus principle using pen-like injectors led to an improvement of both metabolic control of the patients and their quality of life. It is, however, mandatory that they are properly instructed and willing to perform regular home monitoring of blood glucose.