[A pen-injector of insulin in young diabetics: freedom and excessive weight gain].

This study was undertaken to evaluate the use of a pen injector (Novopen) in 23 type I diabetic adolescents and young adults between 14 and 28 years of age. All patients were diabetic before age 15 and the duration of diabetes varied from 5 to 23 years. All patients were previously treated with a conventional regimen of Actrapid HM and Monotard HM or Protaphane HM twice daily (0.98 +/- 0.24 U/kg/day). The patients used Novopen to inject Actrapid HM in a bolus regimen with Ultratard HM as basal insulin, administered before bedtime. The mean duration of the Novopen experience was 8.1 months [1-12]. During the first 4 months after transfer to Novopen, the total daily dosage of insulin was higher than 1 U/kg; afterwards the insulin needs decreased to 0.8 U/kg (at 12 months). On the other hand, the weight/height ratio increased significantly from the 4th month. After one year, the mean increase was 14%. The "objective" determination of metabolic control was obtained by measuring total glycosylated haemoglobin, the mean level of which was unchanged after the transfer to Novopen. The patients' self evaluation of the therapy was documented by asking them to fill in a questionnaire. Results were as follows: 91% of the patients considered the use of Novopen more pleasant than the previous injection therapy; 87% reported a greater freedom regarding diet; 83% found Novopen easier to handle than syringes; 74% experienced greater freedom in everyday life; 70% found the injection by Novopen less painful; 61% considered that their metabolic control improved; 39% experienced minor signs of hypoglycaemia more frequently; 100% wanted to continue on Novopen.(ABSTRACT TRUNCATED AT 250 WORDS)