Type I Diabetics take insulin every day to keep their blood sugar levels under control.  Years ago, there was some question whether the long term complications of diabetes with conventional therapy.  "Intensive therapy consisted of three or more daily doses of regular insulin administered by injection or insulin pump; conventional therapy consisted of one or two daily injections of regular or intermediate acting insulins."

It turns out that that patients doing the intensive therapy had up to 75% fewer so-called "microvascular complications," such as less damage to the retina of the eye from blood vessel changes of diabetes.  This intensive therapy group also had about half as many cardiovascular events than did the conventional treatment group.

These intensive therapy programs are carried out at home by patients using available test kits and insulin products, but they do require more effort on the part of the patient and doctor.  In addition to more frequent insulin doses, there are other things type I diabetics can do to achieve tighter control of their bedtime, to teaching family and friends to recognize emergencies the patient might have.  For more information on tight control of diabetes, access our web site, speakingofhealth.com.  Speaking of Health, I'm Dr. Steven Andrew Davis, for CBS News.

Ref:  American Family Physician
Reichard, p. N Engl J. Med 1993;329:304-9.
The Diabetes Control and Complications Trial Research Group. N Engl J Med. 1993:329:977-86.
The Diabetes Control and Complications Trial Research Group. Am J Cardiol 1195;75:894-903.
American Diabetes Association.  Clinical practice recommendations 1997. Diab Care 1997; Suppl 1: S1-S70.
The following is reproduced from American Family Physician 1999.
EDUCATIONAL GUIDELINES FOR ACHIEVING TIGHT CONTROL OF TYPE I DIABETES
Keep blood glucose levels within the normal range as much as possible.
Test blood glucose levels regularly, especially before bedtime.
Use regular insulin (Humalin-R) or insulin lispro (Humalog) before each meal.
Carry a syringe loaded with regular or insulin lispro.
Use a small dose of insulin zinc suspension (Lente) or isophane insulin suspension (NPH) at bedtime.
Know the onset, peak and duration of effect of the insulins you use.
Eat a prudent diet.
Exercise regularly.
Limit alcohol consumption to moderate amounts.
Learn the signs, symptoms and management of hypoglycemia.
Always carry a source of sugar.
Teach family, friends and coworkers about hypoglycemia.
Keep glucagon at home.
Call 911 only in an emergency.
Wear a medical alert bracelet or necklace.
Recognize and mange the effects of stress on blood sugar levels improve your sense of well-being.
Become empowered and take control.
Lead a "normal" life.
Work to prevent the complications of diabetes.
For more information, contact the web site of the American Academy of Family Physicians ( http://www.familydoctor.org )
or the American Diabetes Association ( http://www.diabetes.org )