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6.1 Insulin therapy Absolute insulin deficiency is the main characteristic of PDM that makes insulin replacement the foundation of its treatment ( 6.1.1 Principles of insulin therapy The most flexible option from a physiological point of view is the basal-bolus regimen, which comprises basal insulins of long-acting formulations such as glargine and degludec, and rapid-acting insulins at meal-time

doi: 10.1093/aje/kwm106 3 BondsDELarsonJCSchwartzAVStrotmeyerESRobbinsJRodriguezBLet al

doi: 10.1080/01616412.2016.1145914 198 PanagakiTMichaelMHolscherC

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Key findings: Pancreatogenic Diabetes Mellitus is characterised by progressive insulin deficiency, impaired glucagon counterregulation, and exocrine pancreatic insufficiency, often accompanied by malnutrition and glycaemic instability

As these medications reduce overall energy intake, individuals are consuming fewer calories with estimates placing this reduction between 16 and 39%, or about 700 calories per day on average (Christensen et al., 2024)