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Re: [IP] PROTOCOLS for SELECTING and ASSESSING INSULIN PUMP USERS



Boy, I don't like this thing at all!  I see that almost any diabetic, unless 
they never go below 70 or above 120, will fit the indications, but the idea 
that it could be denied for "sociological" reasons, or even "potential... 
user's motivation," is distressing.  I sure would be hoppin' mad if some 
doctor decided I wasn't motivated enough or too irresponsible or whatever.  
That would probably make me even madder than the dumb docs you hear about 
who just don't think it's necessary or a good idea.

Jayne.


>PROTOCOLS for SELECTING and ASSESSING INSULIN PUMP USERS
>
>A process for selecting insulin pump users, using a list of indications
>and contraindications for insulin pump therapy.
>Which patients are candidates for Insulin Pump Therapy?
>Such decisions will be based on objective and subjective criteria
>evaluated by the health care team.  They will evaluate:
>X      The potential insulin pump users motivation
>X      Clinical indications
>X      Sociological indications
>X      Any contraindications
>
>This process will ensure that the therapy is safe and appropriate for
>the individual.
>Insulin Pump User Selection
>___________________________________________
>
>Policy on Indications
>There are several common indications for insulin pump therapy
>(Strowig, 1993, Farkas-Hirsch et al.. 1987, Farkas-Hirsch, 1992,
>Etkind, 1988, Forecast, 1982, DOCT, 1993, Marcus, 1992, Jornsay et al.,
>1987, RodenstocketaL, 1985).
>When any of these indications are identified, you can consider insulin
>pump therapy (listed in alphabetical order):
>Clinical Indications:
>X      Dawn Phenomenon
>X      hypoglycemic unawareness
>X      post renal transplant
>X      pregnancy, or planning for pregnancy
>X       retinopathy, nephropathy, or neuropathy
>X      too-frequent hypoglycemia or hyperglycemia
>X       unacceptable diabetes control
>
>Sociological Indications:
>X      desire to achieve near normal glycemia with a proven ability
>to implement intensive therapy
>X      financial resources to meet costs of intensive therapy
>X      insulin pump user preference
>X      realistic expectations of insulin pump therapy
>X      shift work, frequent or extensive travel, variable exercise
>schedules, erratic lifestyle, variable meal schedules and unpredictable
>food selection options
>X      sufficient intellectual capacity and technical ability, or close
>support
>----------------------------------------------------------
>for HELP or to subscribe/unsubscribe, contact: HELP@insulin-pumpers.org
>send a DONATION http://www.Insulin-Pumpers.org/donate.shtml




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