Scientific basis of clinical neurology

This text should be a useful addition to the library of those physicians who are responsible for caring for large numbers of patients with insulindependent diabetes.

Abstract

Although many therapeutic measures involv­ ing insulin have been used for patients with brittle diabetes—including continuous subcutaneous in­ fusion, special subcutaneous infusion regimens, intravenous infusion, and intraperitoneal admin­ istration—the general theme reflected in the case series from various institutions reported in the book suggests that these patients remain difficult to manage appropriately. The general consensus best summarized by Tattersall and Walford is that emotional stress is usually a principal compo­ nent of the etiology of brittle diabetes giving rise to deliberate or unconscious manipulation of the illness to allow the patient to escape an otherwise untenable situation. The chapters entitled Quantification of Brittle Diabetes (by John C. Pickup) and Cheating and Manipulation (by Robert Tattersall and Simon Walford) are especially well written and helpful. This text should be a useful addition to the library of those physicians who are responsible for caring for large numbers of patients with insulindependent diabetes.