I have tried to provide a conceptual framework for approaching insulin therapy in type 1 diabetes. This is not to say it is easy. One of the key messages is individualization—identify your patient's lifestyle and habits, and design an insulin program that incorporates these elements. Basal-bolus insulin regimens are not burdens for patients; they free them to live the kind of life they want. The concept of individualization should not be interpreted as lacking any principle as to how to design an insulin program, that we make it up as we go—just the opposite. This chapter provides a clear system that entails getting to know your patients, and their getting to know themselves better through intensive diabetes and dietary education. An insulin program is chosen that provides flexibility for the identified lifestyle factors, and starting dosages are calculated based on physiological and mathematical principles. SBGM is used to tweak the doses, and also to help the patient identify what factors vary their glycemia and require algorithm counteradjustments. Success is patients' attaining their target HbA,c, relatively free of hypoglycemia and pursuing the kind of life they want.
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