By Arnold Ehret
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Alternatively profiles of four or more readings may be done on selected days during the week. More intensive monitoring is recommended during intercurrent illness and when insulin treatment is being changed or adjusted. Among the more tangible benefits of self-monitoring are that the technique allows patients to recognize that certain symptoms represent hypoglycemia and that the ingestion of certain foods leads to an unacceptable increase in blood glucose concentration. It also allows the assessment of the individual’s glucose response to various types of exercise.
Among sulfonylureas, there is a wide variation in half-life, ranging from 3–8 h (tolbutamide) to 35 h (chlorpropamide). Side-effects, such as skin rashes, are relatively uncommon with the exception of hypoglycemia. Particular caution should be taken in type 2 diabetic patients with renal failure. Sulfonylureas have a tendency to produce weight gain, although any intervention that improves diabetic control in a patient following an isocaloric diet would be expected to result in such an effect. Metformin Metformin lowers plasma glucose by inhibiting hepatic glucose production and increasing the sensitivity of peripheral tissue to insulin.
Pancreas and islet transplantation for patients with diabetes. Diabetes Care 2000; 23: 112–16 Shapiro AM, Lakey JR, Ryan EA, et al. Islet transplantation in seven patients with type I diabetes mellitus using a glucocorticoid-free immunosuppressive regimen. N Engl J Med 2000; 343: 230–8 Shapiro JAM, Ryan EA, Paty BW, Lakey JRT. Pancreas and islet transplantation. In Pickup J, Williams G, eds. 18 Sutherland DER, Gruessner RWG, Dunn DL, et al. Lessons learned from more than 1000 pancreas transplants at a single institution.