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Cases illustrating problems with insulin therapy for diabetes mellitus

David K McCulloch, MD
Section Editor
David M Nathan, MD
Deputy Editor
Jean E Mulder, MD


The following cases illustrate some of the common problems that may arise during intensive insulin therapy in patients with type 1 diabetes mellitus. (See "Management of blood glucose in adults with type 1 diabetes mellitus".)


A 57-year-old hospital administrator who has had type 1 diabetes for 15 years is trying very hard to maintain strict glycemic control. She keeps fit with exercise, and adjusts not only her insulin dose but also her food intake and exercise pattern in response to her blood glucose concentrations.

Her usual insulin doses are:

Before breakfast – 6 units regular insulin and 26 units NPH insulin

Before lunch – 4 units regular insulin

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Literature review current through: Nov 2017. | This topic last updated: Jul 27, 2017.
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