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Re: [IP] Professional advice (LONG)
> 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 agree with Michael 100%.
Luckily, attitudes change. My peds endos at Arkansas Children's Hosp were
anti-pump just a few years ago. They are now very pro-pump. One of our
premier journals, Pediatrics, had an article in the Feb 2001 issue from A.
K. Maniatis et al that stated: "Conclusions. CSII (medicalese for
pump)therapy is an appropriate option for some children in routine pediatric
diabetes care. It can effectively decrease the HbA1c and reduce hypoglycemic
episodes, without producing an abnormal increase in BMI (body mass index)."
This is a small study but it is a step in the right direction.
A quote from a review in Pediatrics in Review from 1997: "Because young
children may be more sensitive to severe hypoglycemia, and this group was
not evaluated specifically in the DCCT, questions remain of whether the risk
of recurrent hypoglycemia is too great to justify advocating intensive
management protocols in very young people who have diabetes." I beleave the
fear of severe hypos is the driving force behind some of the sayings from
the medical community. Hopefully, some researcher will look at this area
Education is the key. Michael, keep up the good work.
Steve McNabb, MD
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