When I saw a media alert recently about a new book on the "functional use of insulin," I jumped at the chance to order a review copy. I'm sure I'm not using the stuff as well as I could be, and this little 190-page volume looked like a great way to brush up on my skills.

Turns out the book is designed as an introduction to, and supplementary part of, a diabetes education course in something called "Functional Insulin Treatment," designed by Dr. Kinga Howorka and his team in Vienna, Austria.

Initially this was a disappointment, because the authors specially state that they don't recommend anyone trying to implement the program on their own just by reading this book. You're supposed to work with a trained healthcare professional, and there are only a few people in this country offering anything similar — arrrrgghh!

But fortunately I took some time to look the book over anyway. On first glance, it appears like a mini-text book, with tiny print and many complex graphs. How engaging can that be to read?

BUT the closer I looked, I realized that between the detailed descriptions of FIT therapy*, the book is packed with some of the best diabetes Q&A I have ever seen — addressing everything from insulin algorithms to when to see an obstetrician. There are also a number of quizzes in the book that are very informative. I nearly flunked out on Dr. H's "basic diabetes training," so clearly there's a lot to be learned here.

Although the whole concept of FIT therapy confused me a bit...

The core idea is a "new approach" to insulin delivery described as "separate replacement" of:

  • Basal - insulin necessary to sustain the body while fasting, and
  • Prandial - or meal-related insulin, and
  • Correction insulin - necessary to lower blood glucose levels to the preferred target.
  • You are tasked to "adjust the insulin supply you need with 4 to 6 daily insulin injections, using numerous injections of short-acting and long-acting insulin or with an insulin pump."

    Despite a fancy chart showing how this differs from "conventional" and "intensified" insulin therapy, I'm not sure it's really that new; it just appears to be a very proactive, assertive approach to managing your BG levels by understanding the various types of insulin well, and testing and dosing VERY FREQUENTLY. Which is a good idea, I am sure — but also kind of hard to keep up, as we all know.

    There's a lot of talk about "insulin kinetics" — understanding the curves of when certain insulins peak in your body. And quite a few example scenarios are offered, encouraging the reader to figure out what went wrong or right with post-meal BG levels. All useful stuff.

    The trouble with intensive therapy is that it's ... intensive. That is, difficult to master (Dr. H recommends 30-40 hours of initial training!), and difficult to maintain over time (he recommends a refresher course every two years). What a dream to imagine that the US healthcare system would invest in empowering, training and educating people with diabetes this way, instead of just reluctantly covering the "co-morbidities" including blindness, amputations, kidney and heart failure. Grrr.

    If you are ambitious about perfecting your insulin adjustments — and curious about best practices from other countries — then the Functional Use of Insulin would be a good read for you.

    {Springer press; not cheap at $24 for the paperback on Amazon.com}



    The DMBooks Giveaway

    Once again, we're offering readers a chance to win a free copy of a book reviewed here at the 'Mine.

    Entering for your chance to win this book, Diabetes? Insulin Dependent? Functional Use of Insulin, is as easy as leaving a comment!

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    1. Post your comment below and include the codeword "DMBooks" somewhere in the comment (beginning, end, in parenthesis, in bold, whatever). That will let us know that you would like to be entered in the giveaway. You can still leave a comment without entering, but if you want to be considered to win the book, please remember to include "DMBooks."

    2. This week, you have until Sunday, June 26, at noon PST to enter. A valid email address is required to win.

    3. The winner will be chosen using Random.org.

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    The contest is open to anyone, anywhere. Viel Gluck, Alle! (That's Good Luck in German)

    Disclaimer: Content created by the Diabetes Mine team. For more details click here.


    This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.