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Re: [IPk] Reason for age given

On Tue, 11 Jul 2000, you wrote:

>Jeremy - Where are you getting this idea that control by pump fades after a

Jeremy's argument seems to me to be flawed in one major respect.
As I understand it, he is saying that because the pump brings better
control, hypo unawareness and an ensuing loss of control is inevitable (or
at least likely) after a certain period of time. In his experience, this
was 15 years. As an argument against the widespread use of pumps in young
children, this doesn't seem to hold water, the reason being that there are
two alternatives.
1) the child has very tight control using MDI. In this case, a similar
fading in control is just as likely to occur after roughly the same period
of time.
2) the child has poorer control. In this case, 10 years or so of poor
control can lead to irreversible complications. Having experienced exactly
this phenomenon,  I know which option I would choose every time. 
Jeremy claims that 10 years of poor control as a child is unlikely to lead
to complications. I would disagree strongly here. Think of the number of
type IIs who have complications because they have had undiagnosed DM for 5
years or so. There may be a difference due to age, but as far as I know,
this is yet to be proven, and is not something I would want to risk.
Secondly, I may be an exception, but I strongly believe that the several
years I spent as a teenager with poor control strongly
contributed to my complications, even if they weren't wholly responsible.

Di, back to calm and rationality, I hope.
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