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Re: [IPk] Response to emails received

>Re.  Standard deviation (use of re diabetic control) surely it is not too
>difficult to realise whether it is high or low, if one keeps records of
>test results and the knowledge of it can only really be of use if it is
>low. Having been using a pump for many years and having achieved a vastly
>improved control (low standard deviation) as the years have progressed (the
>last 2-3 years) my control has become more and more difficult to maintain -
>I suggest that the body, in time, overcomes external controls, but my
>control is still much better now than in 1980 and I have warnings of low
>blood sugars, which had been lost in the twenty plus years of diabetes
>before my first use of a pump. I must note that I did not finish my maths
>degree because the consultants at The Radcliffe (Oxford) insisted on
>changing my insulin (from PZI & Soluble to Monotard) which caused me to
>have hypos every other day, so my memory of standard deviation may be not
>as good as it should.
Just to say that I have enjoyed the more combative tone of the
correspondence of the last few days immensely, (not that I was not also
interested in the recent messages about where girls hide the pump when they
go out - I'll just say on that count (but as a non-girl) that mine sits
rather obviously in my shirt pocket with the teflon tube spiralling out and
then disappearing back into my shirt, and I have rarely been asked what it
was, though I have not had that many close encounters with strangers to put
that practice to the test).

 I do think that as patients we should have an attitude which encourages
those in a position to do so to seek improvements in treatment - after all,
we have a pretty good argument on our side that it will cost less in the end
to keep us healthy and functional for as long as the average member of

On the issue of standard deviation, which Jeremy Grainger takes up,  I don't
wish to start a polemical debate but, to be clear, as I have understood it:
as a statistical measure, a particular standard deviation value is not to be
regarded as a goal of treatment, or in any way indicative of good/bad
control, but simply an individual indication of the variability of the
inputted bg values. It therefore provides a useful basis on which tailor any
adjustments you may wish to make to your doses. (If someone knows of a way
of targetting this variability directly, let's hear about it!)
There is nothing of a black art about this: diabetic software packages will
make the calculation for you (as will Microsoft EXCEL) together with a
number of other analyses which help focus on influencing the "norm", rather
than the eye-catching exception which is relatively insignificant in the
overall picture.

On the general subject of interpreting the data we collect from day to day,
is it too much to expect in this day and age that all specialists should
have a laptop on their desk to load the data from your meter and look at it
with you when you go to visit them? Apart from anything else it would save
them time!

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