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Re: [IPk] Attitudes of Health professionals RE funding

. I find it amazing that in all areas some
> Drs still have such a commanding presence and they are so surprised that
> patients should question THEIR decision.
> I was alarmed at the attitude
> of the nurses -who were a lot younger than me, the way they catagorise
> people with our condition and were so willing to condemn people who do not
> comply in their eyes (or else patronise which is why I did not admit to
> being afflictrd!)  >
Heard it so many times before
went to a meeting last Novemeber. Diabetes consultant presenting about the
wonders of glargine. (Now don't get me wrong I know it works superb for most
people and is vastly better than NPH)
He discussed some cases at the end and how we would manage them: one was a
teacher in her 30s who wanted to start a family. She was supposedly " well
motivated" but was on twice daily mixtard with HbA1c of 8.1%. Young
assistant ( who is actually a part itme GP as well as working in diab
clinic) came up with" I,d nag her about her lifestyle"
8.1 % on mixtard is a bloody miracle as far as I can see. But it is
immediately " lifestyle" and I feel like screaming. Type 1 is not a
lifestyle disease it is auto immune in aetiology as we are all well aware. I
feel that the lifestyle argument is put across to justify denying proper
care or even being bloody bothered to inform themselves of modern therapy.
Unsuitable lifestyle covers a myriad of things not just smoker, poor eating
habits etc but anyone who has a job or profession or engages in leisure
activities and prefers to eat meals whenever friends, peers of family do
rather than at rigid preset times and stick to an exact routine, basically
not subordinating their while life to their diabetes. How can other doctors
be so arrogant?. Patients it seems are expected to go to any lengths and
make any quality of life sacrifices and lead pateint uncomplaining little
lives and smile bravely and talk about how wonderful life with DM can be,
but if they ask questions, want to be empowered and really take control and
fit diabetes to their lives with very frequent testing plus pump if
necessary they are neurotic/ obsessive or demanding and unreasonable.
Control at any expense as long as only to the patient not the NHS or rest of

Most professionals don't understand that glargine won't work all the time
becasue they don't accept that some people can require diffrent insulin at
different times of day. If you mention this ( to a rep working with lantus
who used to be a D nurse) they will come up with( oh you give novorapid
before meals). They can't evenunderstand the difference between basal and

I think this lifestyle argument is going to prevent many people from
benefitting from CSII for a while yet. Even if NICE gives the go ahead for
CSII funding in the event of MDI incl glargine failure then it seems
pateints can still be fobbed off with this lifestyle argument. Not
necessarily in a condemnatory way but " Oh you are stressed at the moment.
Things will settle down etc" or it's because your routine has changed( 6
months after  this change has occured and one would have hoped that it would
have been possible to accomodate this by altering dosage or regimen)

However nicely they put this to you it is still happening. Dmers are still
not allowed a life and reasonable control. And in some cases neither of the
two. What is equally worrying is pateints being emotionally bullied becasue
control is suboptimal and NSF targets are not being met, but still being
denied modern therapy
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