Intensive Management of Type 1 Diabetes in Adults: One Centre Experience 1970–2022

Abstract

This chapter deals with clinical trials and routine management of persons with type 1 diabetes (PWD1) carried out at the Teaching Hospital and Palacký University Olomouc since 1970 in cooperation with experts from other centres. The following outcomes are presented: (1) physical training resulted in (a) enhancement of physical working capacity; (b) increased insulin effectiveness (c) increased S-HDL cholesterol; (d) improvement of neuropathy, memory, attention and general condition of PWD1. (2) Intensive basal and prandial insulin substitution with only short-acting insulin given seven times a day and night appeared to be the most effective approach to the conventional insulin substitution; group education and pens motivated to the intensification of insulin therapy. (3) Continuous subcutaneous insulin infusion, conventional self-monitoring, continuous/flush glucose monitoring and prolongation of time in range opened new horizons. Intensive education, early application of hybrid insulin pumps and specialised prevention of late diabetes complications are deemed to improve the life expectancy and quality. Cooperation with insurance companies should be acknowledged.