Fourteen patients with labile diabetes were treated with divided daily doses of crystalline insulin (Cl). Prior to the exclusive use of CI the patients had been treated with protamine zinc insulin and crystalline insulin given separately or mixed, isophane (NPH) or lente insulin in single or divided doses, isophane (NPH) or lente plus crystalline insulin, or globin insulin alone, all of which provided unsatisfactory management. The CI was given in four daily injections, one before each meal and a small dose between midnight and 2:00 a. m. Despite the disadvantages of the nightly injections none of the patients insisted on resuming his previous insulin program. Divided daily doses of CI gave improved control of blood and urine sugar levels and diminished frequency and severity of insulin hypoglycemia.
Wildberger HL, Ricketts HT. MULTIPLE INJECTIONS OF CRYSTALLINE INSULIN IN TREATMENT OF LABILE DIABETES. JAMA. 1960;172(7):655–658. doi:https://doi.org/10.1001/jama.1960.03020070013004
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