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Re: [IPk] NICE Appraisal

>Well, I generally agreed with what was said, although the emphasis is a
>little odd.  For example, on 4.3.3.:
>4.3.3  The Committee heard evidence about the stringency of requirements
>necessary for people to use an insulin pump successfully, including
>scrupulous cleanliness, blood testing four times a day, estimating
>carbohydrate and calorie consumption throughout every day, moving the
>cannula site every 2 to 3 days, and programming the pump. The Committee
>believed that CSII therapy could be used only by those who were able to
>make a considerable commitment to the technology and who had the ability
>and determination to keep their blood sugar levels controlled.

My partner recently chastised me (and you as well, John Davis, although you 
weren't there - not fair, really!) for saying 'the pump won't suit some 
people'. She rightly pointed out that it's not the _person_ but the 
_behaviour_ that's important - and as with driving, people can be educated.

It's very much about using a social model of diabetes rather than a medical 
model, and going by the statement above, NICE hasn't adopted this approach. 
A social model looks at modifying behaviours and empowering the individual, 
while a medical model gives rigid guidelines that everyone must meet.


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