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Re: [IPk] NICE

In a message dated 1/24/2003 7:26:22 PM GMT Standard Time, 
email @ redacted writes:

> final appraisal determination is now on website
> suggests that pump therapy to be used in event of MDI incl glargine failure
> established users get funding if return to MDI incl glargine fails or deemed
> innapropriate by consultant
> NB failure means A1c> 7.5 or ( i particularly dislike the way this is 
> phrased)
> unpredictable severe hypos requiring help of others and having adverse 
> effect
> on QOL

Hi Abi.  I've just waded through the 27 page document...

Note no refund for pumps already (and consumables previously) purchased.

I too have major concerns about one of the criteria for consideration for a 
pump being that you must have "disabling hypoglycaemia" which requires third 
party assistance. Strikes me that only a diabetic can understand just how 
disabling any hypo can be - not just a quick half hour of inconvenience, the 
whole day can be shot.  Why can't a dreadful QoL, because of swinging bgs, be 
a criterion in its own right?  (You KNOW why - nobody in the NICE group has 
ever had a hypo...)

The way I read the paper, you must have disabling hypoglycaemia which is ALSO 
"associated with significant adverse effect on quality of life".  I.e. both. 
The definition of disabling hypoglycaemia would tend to exclude me (are a few 
examples of needing third party assistance good enough? - does other half 
feeding me sugar sarnies count?).  And I'm a professional with complications 
which have affected and will shorten my working and personal life, and which 
could have been avoided.

I am also concerned about the attitude to "wonder-drug" glargine in the 
report.  Sorry to go on about this again, but why is it assumed that everyone 
has flat basal rates? (I am assuming here that the concept of basal rates was 
understood by the NICE committee and their advisors...)

IDDM 30 year+, 508 2+
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