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RE: [IPk] Poss. sources of info.
Unfortunately - for some reason - Bournemouth Diabetes Dietitians were
not listed. We are dealing with insulin pumps down here as part of the
disetronic trial but also work with some patients on minimed pumps too.
> -----Original Message-----
> From: Jeremy GRAINGER [SMTP:email @ redacted]
> Sent: 22 January 2000 00:32
> To: email @ redacted
> Subject: [IPk] Poss. sources of info.
> For those trying to get every source of information, to find things
> out or
> use to persuade their consultants or whatever, the following may (or
> be of some use to some.
> A booklet is published (I think annually) called 'The Directory of
> Care', the latest current edition is 1999. It includes every diabetic
> clinic in the country and every DSN, consultant, dietitian etc
> with diabetic care (research fellows etc are not included). It might
> helpful if your consultant refuses to have anything to do with pumps,
> that it can be used as a source to find where 'good' consultants do
> and if people so wished be used to create a blacklist of places to
> The web & email of the publishers are:
> http://www.cmadata.co.uk email @ redacted
> Although somewhat dated a research project was carried out by the
> for Diabetes Control' in the mid eighties which proved that pumps did
> cause deaths (a fact which many doctors believe). Ref. Teutsch SM,
> WH, Dwyer DM, et al Mortality among diabetic patients using CSII
> pumps; N
> Engl J Med 1984-310(6)-361-8
> Other books/articles are 'The insulin pump Therapy Book', 1995
> 'Reduction of severe hypoglycemic events in type1 diabetic patients
> CSII' Diabetic Res 1988;8(4):189-93 (Eichner HI, Selam JL, Holleman
> CB, et al)
> 'Pathogenisis and prevention of the dawn phenomenon in diabetic
> treated with CSII' Diabetes 1986;35(1):78-82 (Koivisto VA,
> Yki-Jarvinen H,
> Helve E, et al)
> 'Patient selection for insulin pump therapy' Pract Diabetol
> (Marcus AO)
> 'Psycological impact of CSII pump therapy in non-selected newly
> type1 diabetic children: evaluation after two years of therapy.'
> Metab 1990;16(4):273-7 (Slijper FM, De Beaufort CE, Bruining GJ, et
> 'CSII for the treatment of diabetic patients with hypoglycemia
> unawareness' Diab Nutr Metab 1991;4:41-3 (Hirsch IB, Farkas-Hirsch R,
> Cryer PE)
> 'Successful long term pump use and SMBG in 205 patients' Diabetes
> 1994;43(Suppl1):691 (Bode BW, Steed D, Davidson PC)
> 'Long-term safety, efficacy and side effects of CSII treatment for
> diabetes mellitus: a one centre experience' Diabetologia
> (Chantelau E, Spraul M, Mulhauser I, et al)
> The DCCT trial provides very useful information (re. intensive
> Most of the above references are taken from an article called Insulin
> Therapy, in which it includes reasons for discontinuation which are
> as i) infections, ii) inconvenience, iii) lack of metabolic
> Long term(?) discontinuation rates are given between 10 - 20%
> Pfizer is listed as offering 'More detailed information on request'
> regard to Prescribing Information (this may only be relevant to USA).
> Most of the above is only relevant to medical trials of CSII, but if
> one is
> trying to get financial help the more relevant information you can
> the better your chance.
> It might be helpful to locate your LDSAG (Local Diabetes Services
> Group), if lucky there may be someone within the group with knowledge
> CSII who might be able to offer you great help - these groups have
> local health to improve services in bad areas a lot in recent years.
> Contact the BDA to find out who to contact.
> Your CHC and MP are the most able to get help for you, but the way
> your MP
> reacts is not predictable. It can be worth writing to the chief-exec
> of the
> hospital trust at which you are seen for diabetes, but again his/her
> reaction can be anything, although if you get a letter in return
> there is no benefit with pumps, make sure you keep it, because with
> evidence to prove that pumps are beneficial you can use that against
> person. Unfortunately this may require coming off the pump (for
> reasons) and then showing how control deteriorated. You are then in a
> position to refute doctors who say that you are only badly controlled
> because you make no effort.
> The main thing is never to give up, just go on and on, success can
> come at the most unexpected moments. It is also worth trying to write
> the shadow minister of health, especially at the present moment,
> making a
> letter in the form that indicates the local health authority are
> withholding funds from you that are required for a stable life.
> Best wishes to all,
> for HELP or to subscribe/unsubscribe, contact:
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