Diabetes mellitus type 1 is a form of diabetes in which not enough insulin is produced. The lack of insulin results in high blood sugar levels. The classical symptoms are frequent urination, increased thirst, increased hunger, and weight loss. Additional symptoms may include blurry vision, feeling tired, and poor healing. The cause of type 1 diabetes is unknown. It however is believed to involve a combination of genetic and environmental factors. Type 2diabetes is characterized by chronic hyperglycaemia caused by the combination of insulin resistance and a progressive decline in insulin secretion. However, both fasting and post-prandial blood glucose (PPBG) levels contribute to the HbA1clevel which reflects the mean glucose control for the preceding 3months. Insulin is the main stay of treatment for patients with type 1 diabetes. Insulin is also important in type 2 diabetes when blood glucose levels cannot be controlled by diet, weight loss, exercise, and oral medications. Ideally, insulin should be administered in a manner that mimics the natural pattern of insulin secretion by a healthy pancreas Combination therapy is also very useful in the management of early stages of secondary OHA failure. A frequently advised regimen is the use of along or very long acting insulin at bedtime along with the use of small amounts of an OHA at meal times multiple dose regimens are not very commonly required for the routine management of most NIDDMs. Conventional insulin regimens consist of two injections of short and long-acting insulin, split and mixed regimen. Intensive regimens aim to provide glycemic control within, or close to the normal range, using all available resources for this purpose. This is by far the most popular regimen for intensive insulin therapy. In MSII, the basal insulin is provided by multiple subcutaneous insulin injections, (MSII), continuous subcutaneous insulin infusion (CSII), home blood glucose monitoring (HBGM) Hemoglobin..
