This case study focused on a woman who lived for 91 years, was insulin-dependent for 86 years, and was cared for by the same physician, the author, for over 55 years. In 1932, when she was five years old, she was diagnosed with diabetes. Her diabetes was initially managed with rapid-acting insulin three times a day, then once a day beginning in 1940 with rapid-acting and protamine zinc insulin, pig, then human crystalline zinc insulin, and lastly a mixture of rapid-acting and NPH insulin over the last 16 years. The above treatment plan was created since the patient insisted on a once-daily insulin dose, and all insulins' duration of action was determined to be 24 hours. Continuous overdose of a single insulin has resulted in hypoglycemic episodes almost every day for decades, resulting in excessive blood glucose swings. From the mid-1930s through the 1960s, she used a polarimeter to measure urine glucose, then test strips until the early 1980s, and finally blood glucose self-testing. Her HbA1c levels have been about 7% (53 mmol/mol) over the past 25 years. She did not develop retinopathy or nephropathy; instead, in her latter years, she developed severe neuropathy. Her vision also continued to deteriorate due to age-related dry macular degeneration.
Author(S) Details
József Fövényi
Diabetes Clinic, Péterfy Street Hospital, Budapest, Hungary
View Book:- https://stm.bookpi.org/ETDHR-V6/article/view/6423
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