[Quality control of the self-measurement of blood sugar in unselected type I diabetics. The importance of patient training]. / Qualitätskontrolle der Blutzuckerselbstmessung bei unausgewählten Typ-I-Diabetikern. Bedeutung der Patientenschulung.

Unselected type I diabetics were hospitalized for group training and treatment programme during which blood-sugar was self-monitored with the Haemo-Glukotest 20-800; quality of self-monitoring improved appropriately. The patients had taken part in either the standard training programme (67 patients) or in the "intensive" training programme (101 patients). At the beginning of the training week, after the first theoretical and practical instructions, the quality of blood-sugar self-monitoring was equally poor among patients of both programmes. At the end of the "standard" training week, self-monitoring results were still unsatisfactory, though slightly better than at the onset. Because of these poor results, the training programme was intensified. Optimal quality of self-monitoring was then achieved at the end of the training period. In 69 others, also unselected, type I diabetics the quality of self-monitoring was determined 14 months after their participation in the training programme. Using the Haemo-Glukotest 20-800 (57 patients), self-monitoring gave excellent results; using a blood-glucose measuring instrument (12 patients) it was slightly worse. Assuming intensive training, even unselected type I diabetics can obtain accurate blood-sugar measurements using test-strips.

Diet and pump-treated diabetes: a long-term follow-up.

Long-term effects of a liberalized diabetes diet without meal-planning and food-exchange were investigated in lean type-I diabetic patients treated by continuous subcutaneous insulin infusion (CSII). Food intake, body weight, HbA1c levels and serum lipids were recorded during conventional s.c. insulin injection treatment (CIT) and after 1 month or 14 months of CSII, respectively. During CSII plus liberalized diet, metabolic control improved significantly (compared to previous CIT plus conventional diet) as indicated by a decrease of HbA1c from 9.5% to 7.9% (p less than 0.005). Serum lipids remained unchanged. Body weight did not change significantly during CSII plus liberalized diet; mean body mass index increased from 21.5 to 22.4 kg/m2 (CIT vs. CSII, n.s.). During CSII, eating habits were similar to those of the general West Germany population regarding the number of meals and the nutrients composition. We conclude that during CSII, meal-planning and food-exchange that during CSII, meal-planning and food-exchange can be omitted provided the patients maintain (near-) normoglycaemia by appropriately adjusting the s.c. insulin delivery. Lean type-I diabetics on CSII do not require specific restrictions as to their caloric intake in order to prevent weight gain.