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Re: [IPk] editorial in the British Medical Journal
it seems that the clinics need to get the basics right first! It is not
difficult to test blood sugar, but you do have to have the time and
motivation to do so. Maybe there needs to be education on THAT to start
He doesn't mention too how he is going to divide the money around. It is
not good enough just to say give it to those "few" who want it. The whole
medical profession needs to be reeducated. For instance, at my clinic in
Tower Hamlets, there is not a SINGLE patient on a pump!
Why are the numbers so limited anyway? Obviously the medicos have a vested
interest in not informing their patients about pumps - they must save a lot
of money. Medicos also have to be interested in pumps themselves, and I
still don't believe many of them care.
Just a few of my random thoughts.
>From: "Elizabeth OShea" <email @ redacted>
>Reply-To: email @ redacted
>To: <email @ redacted>
>Subject: [IPk] editorial in the British Medical Journal
>Date: Fri, 25 May 2001 09:04:03 +0100
>HI there -
>The British Medical Journal has an editorial by John Pickup about insulin
>pumps. In part, they say:
>We suggest that a trial of continuous subcutaneous insulin infusion is
>indicated in patients with type 1 diabetes with frequent, unpredictable
>hypoglycaemia or a marked dawn blood glucose rise, whose poor control
>persists in spite of optimised insulin injection therapy (including
>educational support and attention to blood glucose self monitoring and
>injection technique). Some patients who lead unpredictable lives with
>delayed meals experience wide swings in blood glucose concentration and are
>particularly liable to hypoglycaemia when they try to tighten control with
>injection therapy. The few pregnant patients with diabetes who fail to
>achieve impeccable control with injections should also be considered. All
>candidates should be willing to learn about and undertake pump therapy and
>its associated procedures such as regular blood glucose monitoring; this
>includes patients well controlled on insulin injections who simply prefer
>pump therapy and are willing to pay for their pumps and supplies. People
>with psychological problems and major psychiatric disorders tend not to do
>well in meeting the demands of continuous insulin infusion. Proper
>facilities for pump training and medical supervision must be in place. In
>view of the limited numbers of patients and expertise needed, pump care
>should normally be delivered at specialist centres.
>If clinical guidelines on the use of continuous subcutaneous insulin
>infusion can be agreed then NHS funding should also be committed for the
>relatively few patients for whom it will make a difference. For them
>continuous insulin infusion can substantially improve the quality of their
>lives and the course and outcome of their diabetes.
>It seems to me that they're setting too-strict guidelines for pumps. What
>other people think?
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>help SUPPORT Insulin Pumpers http://www.insulin-pumpers.org/donate.shtml
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