Methods and effects of improved conventional insulin treatment in labile insulin-dependent diabetes (IDDM).

In 92 particularly unstable IDDM patients we have tried to avoid any gap in daily insulin supply by applying one out of four newly designed combinations of regular and depot insulin. The short-term effect after three weeks and the long-term effect after greater than or equal to 12 months (data from 30 patients only) of these new regimens were compared with those of the traditional regimen in a retrospective evaluation: Glycemia (level and excursions) was significantly improved both after three weeks of inpatient treatment and after greater than or equal to 12 additional months on outpatient regimen. Serum beta-LP and HbA1 showed slight decrease during long-term follow-up. The majority of the patients reported improved well-being under conditions of daily life. However, the glycemia achieved was still far from the permanent euglycemia aimed at. For the avoidance of any gap in insulin supply in labile diabetics four insulin injections are necessary in most cases. For this, individually tailored combinations of regular and depot insulin must be drawn up carefully together with the patients to avoid a " strait -jacket" system which would not work under conditions of daily life.