[Previous Months][Date Index][Thread Index][Join - Register][Login]
[Message Prev][Message Next][Thread Prev][Thread Next]

Re: [IPk] The pump & hypo awareness

At 10-07-00 18:24 -0800, you wrote:

>My interpretation of your message is that you wish to withold
>a treatment for a chronic disease from someone based on their age so
>that they will appreciate the treatment at some later date. Did I
>mis-read the message?

Yes! I was stating that information has not been collected yet about long 
term use of the pump and I do not believe that anything should be pushed 
forward, with too much haste, where children are concerned until such 
information is collected. Situations can also arise in which machines fail 
to work, this can happen when away from home, on holiday for example. So 
called normal control (MDI) does not involve machines, this is one reason 
why I believe a person should have some experience of controlling their 
diabetes by MDI, so that they can do this easily, if needed. Please note I 
am not trying to suggest that just because someone has never controlled 
their diabetes by such means they would not be able to, but it is much 
easier to do something if you have done it before and have experience of 
its failings. I note that my pump (older version) once stopped working when 
I was in Russia and I only had quick acting insulin (Actrapid) with me. 
Would I return to UK, that day or continue my holiday, injecting many times 
each day? I chose the later, health services in Russia do not support pump use.
I also think that ALL information on children should be collected, to 
discover if problems are apparent. You are probably in a better position 
than medical experts to build such a database, especially given your 
interest in pumps. I will ask you the same question I asked John, how many 
people do you know that have been using a pump for over a decade, or 15 
years. Given where you live you probably do know some, this again could be 
a very important source of information. I do not know of any information 
collected about long term use of the pump. Just because it proves to be an 
excellent form of treatment, for some years does not mean that it will be 
so for ever (until a cure is found).
My thinking is that until information similar to the above is gathered 
caution should be used with pumps and children. For some it would not be 
welcome, I know that when at school I was involved in sport, of the form of 
football (soccer) and rugby, six days a week. There is no way I could have 
done either with a pump connected or even a tender, the result would have 
been that I was involved in more injections every day than without a pump, 
but that is simply a personal view. Most diabetics do not need a pump and 
can maintain reasonable control without.
There are several situations where a pump would provide untellable 
advantage to a child - I am not suggesting that a pump should be withheld 
in such cases, but they are small in number. Too much promotion of pumps 
for children can lead to situations where the parents are over enthused and 
believe that a pump is the only thing for their child. The child may not 
want, or need the pump, but they are still minors and want to keep their 
parents happy and thus accept a pump. As far as the parents are aware the 
child is happy with it. Please do not <rant> about my last sentence, I 
realise such situations are very few, but they do occur.
My concern is that there may be, as yet unknown, problems after using a 
pump for x years. Given that most children can be at least reasonably 
controlled by MDI, I think there is a gain to be achieved by trying to 
control one's disease by different methods, after which the most suitable 
or most preferred can be chosen. When at university I was forced to adopt a 
change in regime, which has affected my career and life ever after. The 
pump while being relatively new and an advance is not suitable for all 
diabetics. I have tried to advance the construction of an implantable pump 
which would work as a pancreas, with methods that overcome all the known 
problems. Please realise that I am very much pro the pump and have been 
since the early eighties.
Nevertheless I think caution should be used regarding children, as I state 
above there are situations in which a pump "must" be used but until there 
is solid evidence of the pump's long term use overzealous promotion should 
be restrained. Remember also that children are minors and can make 
decisions or have them imposed which they soon regret.
I did not suggest that pumps should be withheld from people because of 
their age, I suggested great caution.

for HELP or to subscribe/unsubscribe, contact: HELP@insulin-pumpers.org
help SUPPORT Insulin Pumpers http://www.insulin-pumpers.org/donate.shtml