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Re: [IPk] Pump - Doctor's Comments


She's right, and she's wrong.  The key phrase in her statement is 'that
matter'.  That matter to _what_???  What she means is 'that matter for
the probablity of a long term complication of diabetes'.  She's dead
right.  It doesn't matter whether your bg is constantly 6, or swings
between 2 and 10, but averages 6.  It's the average (6) that matters.

BUT while the average is what controls long-term complications, the
swing has a great impact on quality of life, including ability to earn a
living, care for children and so on.  These highs and lows are difficult
for non-diabetics to appreciate, unless they drink alcohol.  I am not
surprised, but saddened, that your team don't understand what
hypoglycaemia and hyperglycaemia _mean_ to the diabetic.  I explain it
like this: average may be 'sober', but the lows are like 'drunk' and the
highs are like 'hung over' - and while drunk, you can't drive, can't
take care of yourself, or dependants.  And while hung over, your, your
boss and your friends and family are not happy!  Sure, if you spend the
same amount of time 'drunk' and 'hung over' in terms of diabetes, its'
the same as 'sober all the time' - for long term complications.  But its
far from the same in terms of 'a normal life'.  

What pump studies show is that we spend more time 'sober'.  Some studies
(but not all) show that we also have lower averages, and so win both
ways - a better life, _and_ a longer one!  Now, while the 'average'
diabetic may not have a better average bg on a pump than the average
diabetic not on a pump, this is not to say that _you_ wont.  So even if
they don't care tuppence for your quality of life (and do you really
want to be with a doctor who doesn't care that you are drunk half the
time, and hung over half the time, so long as you have an average of
sober????), they can't say _you_ won't benefit because the average
doesn't (that makes as much sense as saying a particular horse won't win
a race because the majority of horses don't win any races). 

Best wishes,

(dm 30, 508 2+, doing rather too much reading lately on statistics,

In message <email @ redacted>,
email @ redacted writes
>Hi everybody,
> I would be interested to hear the comments of all you pumping experts on a
>statement made by the doctor I saw at the Diabetes Clinic yesterday.
 > We were discussing my going on to a pump. (This has been decided with the
>and support of the DSN, but I think the doctor remains uncertain as to the
>merits of a pump in my case.) One of the reasons I gave was better and tighter
>control (i.e. fewer highs and lows) and, hopefully, a better HbA1c.
 > She made this comment, "Successive studies - including studies which have
 >carried out on the same group of people over years and years - have proven
>it is _not_ the swings between low and high that matter, but the _average_ 
>the HbA1c levels). Remember - if I tested my blood after lunch I could be 
 > While I can accept that this may be what studies show, is that the case
 >because the volume of studies on pump users does not yet exist? I know how bad
>feel when I come out of a meeting with a BG of 12+. Given that I am in
>meetings/giving presentations 3-4 days a week, surely these regular highs 
>have at least a long-term effect?
 > I'd be interested to hear your comments, and details of any studies which
>been done on pumpers which showed tighter control and better HbA1c.
>Many thanks,
>for HELP or to subscribe/unsubscribe, contact:

Pat Reynolds
email @ redacted
   "It might look a bit messy now, 
                    but just you come back in 500 years time" 
   (T. Pratchett)
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