From Pretoria, South Africa:
Can diabetes be controlled by changing the insulin before meals as required, or is a set dose before each meal mandatory?
This is good example of where diabetes management could be described as "horses for courses." In other words, there are multiple different ways of doing things. Most children are on relatively fixed doses in relation to what they are about to eat but many adolescents and adults use a variety of the basal-bolus regimen where they take (for example) NPH at bedtime but soluble or Humalog before meals during the day. The latter can then be adjusted to take account of the meal, prevailing blood sugar and impending exercise. This style of management obviously requires a great deal of knowledge about the interaction of all these factors and is usually inappropriate until a patient is very comfortable with the basics. For individuals who have a predictable lifestyle there may be no need for such a complicated system and of course multiple adjustments demands multiple blood tests - not always terribly popular.
Last Updated: Tuesday April 06, 2010 15:09:00
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