Patients with complicated diabetes

Insulin has been used in patients with severe painful diabetic neuropathy, even if their glycaemic balance approximates to normal on oral therapy. The rationale is that aggressive normalization of the blood glucose with insulin may relieve the symptoms. Patients with other tissue damage may benefit.

Patients with severe hypertriglyceridaemia (i.e. 10 mmol/l or more) and diabetes may need very good control and therefore are usually treated with insulin to achieve normoglycaemia and normotriglyceridaemia. A very low fat diet and carefully balanced carbohydrate intake are needed, and lipid-lowering drugs may also be required (p. 137).

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