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[IPk] NICE Appraisal

Hi Rob
Depends what you mean by " last resort"
if you mean because it's the only way the patient manages to spend more time
outside hospital than in eg frequent severe hypos or hypers, or it's the only
way they can hold down a job or have reasonable school attendenance ie
diabetes is immediately disruptive to the life of the patient, the family or
incurs immediate expense to the NHS/ extra work for medics, then no it should
certainly not be left as a last resort because we all deserve far better than
however, the proposals do state that pumps should be funded only if MDI fails
( ie HbA1c> 7.5 or hypo unawareness, severe or frequent hypos, hypos intrusive
to quality of life, despite best attempts of the patient)
So I don't think pumps on the NHS are going to be widely available to anyone
who wants one without trying alternatives first.
I just hope that the proposals are accepted as they are and that patients who
are not doing well on MDI and are motivated are not denied timely access to
pump therapy. (Great habit of clinics to continue on same meds which aren't
working with excuses such as coughs and colds, too many parties, working too
many hours etc. Yes people who have DM have to work, attend school etc too)
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