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Re: [IP] New insulin from Lily-A Completly Different Opinion

Although the quote,

> *Some patients should not aim for near-normal blood glucose levels. In
>> elderly patients who have a life expectancy of less than 5 y or any patient
>> with a terminal disease, tight control is unnecessary.*

is disturbing.  Your web resource is for general ER guidelines.  I must say
that given the demands and nature of ER medicine this is one quote is not
inappropriate in its context.

The article you refer to ends with very specific follow up instructions for
the attending MD dealing with a DM'r showing up in the ER. See the Follow Up

Also let's face facts here, Health Care in the USA is fragmented at best.
While we all may want to have 'one stop care', this is not the reality of
the system(s) in place.  You are absolutely correct that we need to inform
and educate ER staff when we have the chance. However with only 1.4 million
type I, spread over 50 states, I have to say that it is unreasonable to
expect any ER Department to be on the cutting edge of treatment, DM, Cancer,
Coronary, etc.

I know this is upsetting, but this is reality.  We all need to work to
change this, 'Pumps for All' is a great goal. A cure would be to wonderful
to believe, but in the meantime I still say to discount a treatment regime
that is working for and benefiting a patient is unproductive.
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