[Previous Months][Date Index][Thread Index][Join - Register][Login]
[Message Prev][Message Next][Thread Prev][Thread Next]

Re: [IP] Professional advice (LONG)

Roxanne Villanueva  RD, LD wrote:
> My response was not to your specific e-mail, but to the tone on the
> listserv that we professionals with all the alphabet soup after
> names are wrong.  I agree with you that this CDE was 'out on cloud
> nine.'
> For help in setting him straight, I would recommend that you check
> out the DCCT trial info...I can't remember the specifics about the
> study other than the general information that stated that the lower
> the HgbA1c, the less likely the development of complications.  So I
> would extrapolate that controlling BG levels during childhood would
> only benefit this.

<continue rant>

Roxanne is right on, here are some follow on evaluations of the DCCT 
data that extrapolate the study to kids -- they don't have any kid 
info to work with so it's not very convincing from a scientific 

Unfortunately, the postion taken by many professionals is that UNLESS 
there has been a study that conclusively demonstrates that something 
exists, creates and effect, etc..... then it simply is not true. To 
wit... I recently started a firestorm on the peds-endo list when some 
poor doc asked about the advisability of putting a 5 yo on the pump. 
I naturally responded with the information I have about the number of 
kids 5 and under represented here and made the comment (based on 
followup reports to the DCCT) that and insulin pump was the best 
possible tool for control etc......  I was immediately jumped on by a 
bunch of docs who took me to task saying that the DCCT had no young 
participants, did not draw conclusion about kids, their were no other 
studies (this part is not true) , etc..... Thankfully, other 
professionals took up the challenge and provided the references to 
studies, etc....

The point being, there is a wide spread belief among reasonably well 
informed medical professionals that pump use is
1) not necessary as MDI is fine
2) particularly not needed or even beneficial for kids
3) that complications don't occur simply because they are young
.... the list goes on.

In my mind this is just a load of crap. It is my (uninformed of 
course) lay person opinion that these people are afraid of progress 
and simply don't want to be the ones to lay it on the line 
professionally to help their patients. Fortunately, there is also a 
large, and I hope growing, number of professionals that believe 
otherwise, learn quickly from the postive experiences of their 
patients and are willing to try new (are pumps new???) technologies 
and treatements and to extend those treatments in a logical manner 
from their adult patients to kids (hooray!!!). I think the tide is 
shifting in favor of our youngsters, but it is important to CHALLENGE 
the erroneous information put forth like the speaker at the meeting 
that originally started this thread. If I had been their I would have 
stood up in the audience and challenged her directly. I don't really 
care if I make a fool of myself or a scene over an issue such as this 
-- I've done it before and I will do it again. The record must be set 
straight when misinformation hurts us and/or our children.


email @ redacted
for HELP or to subscribe/unsubscribe, contact: HELP@insulin-pumpers.org
send a DONATION http://www.Insulin-Pumpers.org/donate.shtml