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RE: [IP] Children on pumps

On  1 Mar 99 at 7:35, CJ Ferry wrote:

> The current protocols I have found and I have now give a minimum age of 5
> years as opposed to 12 a few years ago.  As for younger than that I have seen
> no protocol or standard of care got younger than that.

I wonder what it takes to develop a protocol or standard of care for younger 
children?  Maybe some doctor's kids need to develop diabetes to provide some 

> Now before anyone on the says, but this or but that, I said I have seen no
> protocol or Standard of Care, if you know of one that exists, please forward
> it to me and remember, something that seems to be missed on the list alot, as
> a medical practitioner, I must only practice within the scope of my practice
> as any other reasonable practitioner would, hence if no Standard of Care
> exists for me or my colleagues, we open ourselves up to liability. ( I have
> added this because of previous private emails attacking and/or pressing that I
> have no idea what I am talking about)

It's the old problem - no one wants to "buck the system" and provide the best 
possible treatment...  It seems like they are more comfortable forcing the 
parents to hear the child beg multiple times each day...  "please Daddy, no 
finger stick." or "please Daddy, no shot, please, no shot, please, please!!!"
Those were the words I heard once when observing a family with a young child...
Of course the "medical professionals" hiding behind their "protocols" don't 
have to hear the child cry while begging for the shot or see the child's father 
try to comfort the child with tears in his eyes...  

Of course we're all such wimps anyway...  haven't they been telling us for 
years that "insulin shots don't hurt" and "you don't bleed after an insulin 
shot"...  the last one was what I was told by a nurse the day after I ruined a 
white shirt becuase my arm bled a lot after a shot...  And I'd bet the same 
people who develop the protocols are some of the same people who are saying 
that the DCCT doesn't really mean anything and as long as you're not "spilling 
sugar" you're OK...  

There will be no protocols developed until they are demanded - and they won't 
be demanded until people start pushing for them.  I don't think there is a 
nebulous "protocol authority" that sits somewhere and thinks up new protocols 
out of the vacuum.  The pioneers who have actually put children on insulin 
pumps need to write down what they do, submit for publication and then maybe 
someone will accept what they have done as a "proper protocol"...    According 
to one of the CDE's near here there still isn't a "protocol" for putting anyone 
under the age of 18 on humalog either, and there isn't an "official protocol" 
for using humalog in the pumps....

Randall P. Winchester
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