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Intensive insulin therapy: Achieving tight blood sugar control

Intensive insulin therapy can help prevent long-term diabetes complications. Consider the benefits — and understand the commitment.

By Mayo Clinic staff

Controlling Your Diabetes

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If you have type 1 diabetes — and in some cases if you have type 2 diabetes — intensive insulin therapy may be the key to long-term health.

This aggressive therapy isn't easy, but the benefits are real. Find out how intensive insulin therapy can help you achieve desired blood sugar control and what intensive insulin therapy requires of you. Then you and your health care team can decide if intensive insulin therapy is the best approach for you.

What is intensive insulin therapy?

Intensive insulin therapy is an aggressive treatment approach designed to control your blood sugar levels. Intensive insulin therapy requires close monitoring of blood sugar levels and frequent doses of insulin.

If you choose to try intensive insulin therapy, you'll work with your doctor to set various goals. Ideally, this means:

  • Blood sugar level before meals: 70 to 130 milligrams per deciliter (mg/dL), or 3.9 to 7.2 millimoles per liter (mmol/L)
  • Blood sugar level two hours after meals: less than 180 mg/dL (10 mmol/L)
  • Hemoglobin A1C (glycated hemoglobin, an indicator of your blood sugar control for the past few months): less than 7 percent

What are the benefits of intensive insulin therapy?

Intensive insulin therapy can prevent or slow the progression of long-term diabetes complications. In fact, in one study, tight control of blood sugar levels reduced the risk of diabetes-related heart attacks and strokes by more than 50 percent.

Older studies provide appealing statistics as well. Intensive insulin therapy can:

  • Reduce the risk of eye damage by more than 75 percent
  • Reduce the risk of nerve damage by 60 percent
  • Prevent or slow the progression of kidney disease by 50 percent

And there's more good news. Intensive insulin therapy can boost your energy and help you feel better in general.

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References
  1. McCulloch DK. Insulin therapy in type 1 diabetes. http://www.uptodate.com/home/index.html. Accessed Sept. 29, 2010.
  2. McCulloch DK. Insulin therapy in type 2 diabetes. http://www.uptodate.com/home/index.html. Accessed Sept. 29, 2010.
  3. DCCT and EDIC: The diabetes control and complications trial and follow-up study. National Diabetes Information Clearinghouse. http://diabetes.niddk.nih.gov/dm/pubs/control. Accessed Oct. 17, 2010.
  4. Checking your blood glucose. American Diabetes Association. http://www.diabetes.org/type-2-diabetes/blood-glucose-checks.jsp. Accessed Oct. 17, 2010.
  5. Tight diabetes control. American Diabetes Association. http://www.diabetes.org/type-1-diabetes/tight-control.jsp. Accessed Oct. 17, 2010.
  6. Zoungas S, et al. Severe hypoglycemia and risks of vascular events and death. The New England Journal of Medicine. 2010;363:1410.
DA00088 Dec. 21, 2010

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