Vnitr Lek 1994, 40(5):306-309

[The effect of intensive insulin therapy on specific long-term complications in type II diabetes].

B Podrouzková: II. interní klinika lékarské fakulty Masarykovy univerzity.

Hundred and ten type 2 diabetics with complications, mean age 58.1 years, were treated intensively with insulin for a 12-month period using CSII in an attempt to stabilize the development of specific complications. During 12 months of treatment their long-term compensation corresponded to a value of 7.8 HbA1c. It proved possible to influence in a favourable way complications in 48 patients, i.e. in 43.6%. The greatest improvement was recorded in peripheral sensory neuropathy, less frequently sensorimotor neuropathy. In patients with nephropathy in 33% quantitative proteinuria dropped below 500 mg/24 hr. Retinopathies were not affected, on the contrary, deterioration was recorded in 18.6% of the patients. Forty-eight diabetics whose condition improved proceeded with intensive insulin therapy (using IKT) for another two years, 62 diabetics whose condition did not improve were treated with insulin in the standard was (1-2 doses per 24 hr.). Evaluation of treatment after two years revealed less progression of complications in the intensively treated group. Intensive insulin treatment leading to close compensation is effective also in type 2 diabetics when specific complications progress.