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Re: [IP] Sliding Scale Insulin Dose

On 21 Feb 98 at 0:06, email @ redacted wrote:

> Once again I am writing for advice.  My daughters Endo and our Pediatrician
> both say they do not believe in doing "sliding scale" for insulin dosages.
> They say we are just trading highs for lows and it is NEVER recommended for
> pediatric treatment of Type 1 Diabetes.   They say what is below the peaks is
> what counts and not the occasional peaks.   Whatever her readings are they
> want me to give the same amount of insulin each day.  (this makes no sense to
> me - why would you give the same amount of insulin for a 300 reading as you
> would for a 90?)

FIND NEW DOCTORS, FAST!  These people are so far out of date that 
they are seriously threatening your daughter's health.  I'd hazard a 
guess that they still recommend urine testing using the tablets and 
color chart too...  At least get in contact with some pediatric 
endo's who are up with current research and not stuck in the 1950's.  
I think that many of the doctors with this kind of attitude just 
don't want to spend the extra effort that it requires of the medical 
team.  They can be lazy and your daughter is the one to suffer.  
Don't pay the bill until you are satisfied with the services being 
rendered - there is an abundance of research that says tight control 
is worth it.  These doctor's sound like they've never bothered to 
read anything from the DCCT or other more recent research.

> Also, as a mother I struggle with not giving her Humalog to bring down an
> occasional high.  This doesn't happen frequently but on occasion it does.  I
> realize if this are happens frequently and we see a trend it is time to change
> the insulin dosage.   To not treat the high bothers me greatly.  When I give
> the extra Humalog I am careful to not do it in conjunction with the NPH peak
> (so far I have never sent her crashing).   Currently she is on a 2 shot/day
> regimin - before breakfast and dinner.  
> If we have the technology available to bring quickly bring down highs then why
> not?  I don't want to be going against our doctors but I am sense there may be
> two schools of thought on this.   Any input will be greatly welcome.  Also if
> I am completely off base please set me straight!  

There are many schools of thought, from the old school that says "we 
can't do anything so why bother" to the new school that seeks tight 
control at all times.  There is a spectrum of practice between these 
viewpoints.  As a consumer you have a right to question these 
doctors.  Ask them if they are willing to sign a document accepting 
responsibility for any long term complications because of their 
laziness?   Hold them accountable for the quality of care they are 

> Sherri Lynn (Laura's mom)   
> Insulin-Pumpers website   http://www.bizsystems.com/Diabetes/
Randall Winchester

* The views expressed here are mine and do not necessarily *
* reflect the official position of my employer.            *
* There's no guarantee on anything said here...
* If I say I understand something completely the only thing
* we can both be assured of is that I must have completely
* misunderstood something. 
Insulin-Pumpers website   http://www.bizsystems.com/Diabetes/