The balance of scientific evidence now favors a relationship between poor metabolic control and diabetic complications. This, coupled with the clinical capability to achieve near-normalization of glycemia, has created an obligation not to deny the option of meticulous control to appropriately selected patients who wish to take this therapeutic course. The training and programming of such patients and the subsequent surveillance is best achieved in specialized centers. It is hoped that the experience accumulated will permit careful analysis as to the long-term value of such therapy in the prophylaxis of diabetic complications.
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