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RE: [IPk] iv correction bolus

At 16-05-00 10:22 +0200, you wrote:

>  Then it was discovered
>that you could reuse needles with no increase in infection rate - and that
>skin swabbing was of no clinical benefit. And now it is shown that you can
>inject through clothing without increasing infections. Strange how practice
>is so often ahead of theory!
Hi John,
About the discovery above you have missed out on not having diabetes before 
disposable syringes. I think the discovery was made very many decades ago. 
The NHS would only prescribe one needle per week, to be used with a glass 
syringe. Our struggle to get pumps paid for is no more difficult (in my 
opinion) than getting disposable syringes was. That was solved because it 
was thought better to let drug addicts (excluding type1 diabetics) have 
free needles - perhaps pumps would be more easily available if drug addicts 
could be proved to be better controlled with pumps (as some forms of pain 
relief post operation are). Any suggestions?
Practice being ahead of theory reminds me of the considerations put forward 
for the "new" name for the BDA. One of them was The Diabetic/tes 
Association. A very strong reply came forth from one member, connected with 
diabetes pre 1954 - I see we are advancing into the new millennium by 
returning to the first half of the 20th century.
Re. The IV injections themselves there is no way I would wish to aim for a 
vein to do an injection. The number of bruises I have received when blood 
has been extracted for testing would turn me off forever. I realise the 
difference between extraction and insertion and would add that the bruises 
have (almost) always come from young male doctors and male heads of 
department but my feelings remain. I also wonder about the probable high 
occurrence of bleeding following such a process and question if elastoplast 
or whatever would also be provided.
I was also interested by your earlier statement about doctors "letting" 
patients measure their own blood sugar. As I remember it was not very long 
after Dextrostix became available (especially via the NHS) that we had them 
to use. They were certainly available long before the blood testing 
machines came into existence.
I am also very uncertain about the benefits IV injections would provide, 
they would not (in most cases) be needed on a regular basis, which I think 
is one of the requirements for maintaining continual good practice, but 
that is a personal view.
I am more aware when my blood sugar is high than low and have taken 
appropriate steps to reduce it, I do not think this requires IV injections. 
During my diabetic lifetime I believe the only incidence of ketosis was 
when I was diagnosed, I believe if one wants to it is possible to control 
diabetes without introducing new (complicated?) procedures. I also ask how 
one can be certain that you have in fact penetrated the vein and remained 
within it before inserting the insulin. The consequences could be that the 
insulin was actually only intramuscular.
Sorry if this is too long.
Cheers Jeremy.

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