WHEN SHOULD STABLE MATURITY-ONSET DIABETICS BE SWITCHED TO INSULIN

  • 1 January 1980
    • journal article
    • research article
    • Vol. 110  (42) , 1534-1537
Abstract
Eleven maturity-onset diabetics (age 55-79 yr) switched from oral hypoglycemics to insulin and even though metabolically stable, were followed up. The main reason for the change was a diminished sense of well-being combined with relatively ill-defined symptoms such as declining physical performance, fatigue, dizziness and pain in the legs. None of the patients was ketoacidotic and the 24 h glucosuria was less than 15 g, although the average fasting blood sugar was markedly elevated to 296 mg/dl. After 6 mo. on insulin the 24 h glucosuria had not changed but the fasting blood sugar had dropped to 183 mg/dl. This was accompanied by an improved sense of well-being (as measured by an analog scale) and by disappearance of the symptoms mentioned above. Even though 9 of the 11 patients were initially reluctant to change to insulin, all 11 were still on this drug after 6 mo. Broadening the indications for insulin therapy in stable adult-onset diabetics is recommended, with particular attention being paid to vague symptoms such as fatigue and decreased physical performance.

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