ABSTRACT
Type 1 diabetes mellitus (DM) afflicts more than 1 million people in the United States, with an annual incidence of at least 13,000, making it the second most common chronic disease in young people [1]. It is the most common cause of end-stage renal failure (ESRF), blindness, and limb amputations, and one of the most common causes of death in the United States [2]. Since the initial success of purifying insulin and treating diabetes in 1921 by Banting and Best, there has been much progress in the effectiveness of insulin therapy, and patients with type 1 diabetes can survive for many years. However, the imperfect control of blood sugar ultimately results in vascular complications in most patients. Meticulous glucose control has been shown to decrease complication rate; however, it is very difficult to achieve and may result in dangerous episodes of hypoglycemia [3]. The estimated annual mortality attributed to insulin-induced hypoglycemia has been reported to be as high as 3%–6% [4].
