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Re: [IP] islet cells for who?

Ruth Schneider wrote:
> "For now, Dr. Shapiro recommends the procedure only for severe Type 1 cases"
> I always thought that IDDM was IDDM.  no "better or worse" cases.  you
> either need insulin or you don't.

In Natalie's utopia, which, of course, is not EVERYONE's utopia :), the
first transplants would go to those who had hypoglycemia unawareness
and/or gastroparesis, because those are the folks for whom diabetes is
most life-threatening, and who CAN'T get good control, pump or no pump! 

Because the transplants are islets, not just beta cells, these people
would regain the ability to control both highs AND lows, and it would
allow them to live  without fear of sudden, severe hypos. And perhaps
normal BGs might help reverse gastroparesis, if it wasn't too far

Islets for those undergoing kidney transplants might be a good thing,
too, because normal BGs REALLY help extend the life of the transplant. 

When a medical resource is insufficient for all those who want it, the
decision as to who gets it and who doesn't is tough -- how do you decide
the merits of any particular case? 

I remember when kidney dialysis first became available, and hospital
boards were making decisions as to who got dialysis and who didn't -- I
remember articles telling about favoring a man who was supporting
children over a single woman who wasn't, or a church-goer over an
atheist! I also remember being horrified about these boards being so
sure that THEIR values should be the deciding factor. 

I would really hope that if this islet transplant procedure DOES prove
to be viable, and available, that the choice wouldn't be so arbitrary --
but at least I can say that, as someone who has no complications and for
whom control IS relatively easy (no hypoglycemia unawareness!), I
WOULDN'T want to be first in line.  

In reply to another note -- it's not true that complications occur only
in those who don't give a darn -- many people try just as hard as they
can, but due to reasons beyond their control, such as genetic makeup and
health-insurance inequities, they develop complications anyway. It's
really a crap shoot, and I wouldn't want to blame anyone for being

Debate is good; I hope there will be just as much debate among those who
have the power to decide!

 ._c- ._c- ._c- ._c- ._c- ._c- ._c- ._c- ._c- ._c- ._c- ._c- ._c- 
 Natalie A. Sera, with all her ducks in a row!
 Type Weird, pumping!
 mailto:email @ redacted
 ._c- ._c- ._c- ._c- ._c- ._c- ._c- ._c-._c- ._c- ._(` ._c- ._c- 
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