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Re: [IPk] JDF meeting

Hi everyone -

I great seeing everyone at the JDF meeting at King's! I had a wonderful day
:-) And my 2 week old son  l o v e s  the Max the MiniMed Moose he was very
thoughtfully given! Thank you Peter :-)

I felt slightly sorry for Dr Peter Watkins, Prof Stepahnie Amiel and Sister
Helen Reid - 3 healthcare professionals who freely gave of their time to
talk about their specialist fields. Little did they know how ruthlessly
they would be grilled in the area of pump therapy by some horribly well
informed members of the audience! But I'm sure they secretly love that sort
of thing...

My "secret agenda" for being there was to try and gauge the underlying
opinions of some of these top diabetes specialists. I don't know what
others felt, but the impression I got - from their talks, answers to
questions from the floor, and in private conversation - was that these
people do appreciate the benefits of pump therapy. But they are in the
position of having to purchase the maximum amount of diabetes care for the
population with a fixed budget. Not easy. And that generally means that
there can be no automatic pump funding without making a very strong fuss.
This isn't necessarily a bad thing - it means that only those who really
want it get it. And they are then far more likely to make the effort to
make pump therapy work.

The result of this is that whenever anyone praises pump therapy, the
doctors have to try and stifle demand by (over)stressing the potential
problems. Hence the cries of disagreement from members of the audience. And
the grilling that Dr Watkins got...

I found it fascinating overhearing Stephanie Amiel telling others privately
how good pump therapy can be. And it was extremely ironic that in her talk
about hypoglycaemia she drew some lovely graphs showing how Insulatard
tends to peek in the middle of the night when least insulin is needed, and
tails off at dawn when most insulin is needed. And 15 minutes later Helen
Reid was lecturing about how pumps can be programmed to give a precisely
defined amount of insulin an any hour of the day or night... this was not
lost on many non-pumping members of the audience!

I was also very interested to hear them talking about the "Dusseldorf
protocols". What they have found at the major diabetes clinic in
Dusseldorf, Germany, is that, contrary to what was discovered in DCCT, on
MDI you can achieve very tight control without an increase in severe
hypoglycaemia. This is achieved by rigorous patient training is quite
complex and innovative use of their insulins. British doctors were
initially very sceptical of this, believing it to be because by nature
German patients are very obedient. But they are now looking at it all
again, and introducing this kind of intensive training to the NHS. I'm
interested to see what comes of it...

Oh, and I'm sorry our little meeting didn't materialise at the end :-( Some
of us finished very late, after a gripping lectire by Stephanie Amiel on
diabetes immunisation and prevention. So many had wandered off. But Di,
Paul Leadbeater (possibly soon a pumper) and I had a great drink in Covent
Garden :-)


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