Showing papers on "Diabetes management published in 1985"

The Etiology of Incapacitating, Brittle Diabetes

Abstract: Incapacitated brittle diabetic subjects are a small subset of insulin-dependent diabetic individuals who are unable to maintain a normal lifestyle because of frequent disruptions secondary to severe hyperglycemic and/or hypoglycemic episodes. Thirty incapacitated patients were referred for evaluation because the cause of their diabetic instability could not be determined by their personal physicians despite extensive patient training in correct diabetes management, frequent hospitalizations for observation, and multiple diagnostic testing. From the 30 patients, a diagnostic algorithm was developed (described in the companion article) from which the etiology of brittle diabetes could be established in 29. This article provides the clinical characteristics of each of the 30 patients, a description of the etiologic categories of brittle diabetes, and the clinical follow-up from the time that the etiologic diagnosis was established and treatment recommended. Although extensive medical records were sent with each patient, without prospective objective testing under rigidly controlled conditions, the correct etiologic diagnosis would not have been evident from the clinical presentation of the patient. Of equal importance in identifying the etiology of brittle diabetes was the acceptance and cooperation of the referring physician in providing close follow-up and repeat insulin challenge testing when necessary. In this referred patient population, eight subjects had factitious disease, eight were malingering, seven had communication deficits, two had gastroparesis, two had systemic insulin resistance, two had miscellaneous causes of brittle diabetes, and one patient remained undiagnosed.(ABSTRACT TRUNCATED AT 250 WORDS)

Community-Based Diabetes Education: An Outreach Program

Abstract: State-of-the-art educational and clinical management services for chronic illness are generally found in referral centers. In Minnesota, those referral centers are based in metropolitan areas and are not easily accessible to people living in small communities or rural areas. In 1979, a pro gram was developed to work with community health pro fessionals to provide and support pediatric diabetes care in nonmetropolitan areas. In the past five years, the Minne sota Diabetes in Youth Program (MDYP) has provided an innovative approach to community-based care for children with diabetes. It emphasizes education for families to help them deal more effectively with diabetes management.

Self-Monitoring of Blood Glucose in Diabetics Treated With Intraperitoneal Insulin

Abstract: To the Editor. —Bergman and Felig's 1 article in theArchivesevaluated methods for self-monitoring of blood glucose by diabetic patients, detailing visual monitoring procedures and meter-reading devices, and the doses of different types of insulin. The important advance these methods represent in diabetes management has great repercussions on the mode of administering insulin, a consideration we missed in the authors' excellent review. We refer to the intraperitoneal administration of insulin and the ease of its dosage by self-monitoring. The treatment of chronic renal failure by continuous ambulatory peritoneal dialysis (CAPD) has given many diabetics access to dialysis, until recently off-limits to these patients because of complications inherent in diabetes mellitus. The best way to control these patients' blood glucose levels is to add insulin to the dialysis fluid introduced into the peritoneal cavity four times a day. This type of dialysis is performed at home, after the patient has

A Team Approach to

Abstract: The American Association of Diabetes Educa tors combines a diversity of professions and practices in its membership. To focus on the spe cial contributions of each discipline a common diabetes management or educational problem will be addressed periodically, using u team app roach.