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email @ redacted [mailto:email @ redacted] wrote:

> - Here's the quote from Drs. Becker and Ryan - the HOWEVER _____ 
> .................
> Pediatric patients who chose therapy with an insulin infusion pump 
> (containing Lispro insulin) also had fewer severe 
> hypoglycemic episodes than 
> those who chose multiple injections. However, a randomized 
> study will be 
> required to prove that the decrease in hypoglycemic events 
> was related to 
> insulin-pump therapy rather than the type of patient who 
> chose this form of 
> therapy.

I'm putting on my professional hat here: I'm not sure how they would go
about distinguishing between the pump itself and the attitude of the pump
user in this case.  As we all know (or most of us, anyway), the pump is not
a panacea, and it requires more, not less, personal involvement with
controlling this damned disease.  A pump being used by someone who did not
invest the time and effort to take advantage of the precision of the pump
would not be likely to show much improvement.  About all it might show is
that Humalog (or Regular) in a pump is better than long lasting insulins in
a syringe (which may be a significant finding in itself).

But the bottom line to me is that I'm not at all sure that these two factors
are statistically distinguishable, and will not be until one has a far more
automated pump (i.e. "artificial pancreas").

Jim Handsfield
Centers for Disease Control and Prevention
mailto:email @ redacted OR
mailto:email @ redacted

The opinions expressed are my own and do not necessarily represent those of
the Centers for Disease Control and Prevention, the United States Public
Health Service or any other agency of the United States government.
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