INFLUENCE OF INTENSIFIED INSULIN REGIMEN ON QUALITY-OF-LIFE AND METABOLIC CONTROL IN INSULIN-DEPENDENT DIABETES-MELLITUS

Seventy-eight non-randomized patients with IDDM, aged 33.8 +/- 9.6 yea rs (mean +/- S.D.), with a duration of diabetes of 16.6 +/- 9.5 years and a HbA(1c) level of 8.0% +/- 1.5 at baseline were included in the s tudy. The effects of a change from a 3-dose insulin regimen using conv entional syringes to a treatment mode using 4 injections per day with a pen injector on metabolic control, perceived distress from diabetes on everyday life and correspondence between expectations and experienc es of treatment during a 1-year trial were assessed. The experience me asures were registered at baseline and after 3 and 12 months, respecti vely. HbA(1c) levels were measured every 3 months. Neither the metabol ic control nor the body mass index or rate of hypoglycemic episodes ch anged during the study,period. However, the patients experienced a dec reased distress from diabetes, which appeared during the first 3 month s and remained unchanged thereafter. The expectations of advantages fr om the intensified insulin therapy were generally high and were mostly either fulfilled or exceeded by experiences. We conclude that multipl e insulin injection therapy, under routine treatment conditions, is su bjectively preferable to patients and has favourable effects on their quality of life although something more is required in order to also a chieve an improvement of metabolic control.