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October 28, 1999

Tight Control

Question from New York, USA:

I was very concerned about what I read in the article entitled Conventional Versus Intensive Diabetes Therapy in Children with Type 1 Diabetes. Could you please explain what is meant by "Intensive Therapy"? Is this maintaining "tight control"?


Yes. Intensified therapy usually includes 3-5 injections of insulin each day coupled with lots of blood glucose monitoring to help guide decisions about food, snacks, activity and insulin. Insulin can be delivered by pump, by needles or indwelling catheters or by pens but the goal of intensified therapy is to bring hemoglobin A1c safely as close to the normal range as possible without causing excessive or severe episodes of hypoglycemia. It’s associated with 35-70% fewer long term complications in the eyes, kidneys, heart, nervous system and cardiovascular system. It’s our standard treatment recommendation for all our patients who are willing to learn it, but it’s more expensive and takes more dedication of the entire family.