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RE: [IPk] Funding of Designated Specialist Centres for Diabetic Insulin Pump Users



There is a trial in some clinic centres which is looking at intensified
therapy more detail for multiple daily injections so hopefully it will
all catch on - I have a mental balnk this morning about what it is
called, a woman's name is as close as I can get this early on. 
Our results here in Bournemouth are good and we now run an intensified
programme every 3 months looking at all aspects of good control.
Hypo/hyper/what the blood tests mean/social and psychological
isses/nutrition and carb assessment/ how to go about varying your dose
for food, sport, sickness, / how does your insulin work...etc.. It has
been on going for almost 18 months and we have good results...more
importantly, participants get lots out of it... and health professionals
do too!

Jules :)
Ms Julette Kentish, BAppSC (NutSc) MND SRD
Diabetes Research & Specialist Dietitian
Royal Bournemouth Hospital
Castle Lane East
Bournemouth BH7 7DW
DORSET UK
ph: 01202 704929
fx: 01202 704759
email: email @ redacted

-----Original Message-----
From: John Neale [mailto:email @ redacted]
Sent: Friday, October 13, 2000 3:14 PM
To: email @ redacted
Subject: Re: [IPk] Funding of Designated Specialist Centres for Diabetic
Insulin Pump Users


I too agree with Ray's observation.

Pump initiation is certainly best performed at a clinic with a thorough
grounding in pump use. But the clinic would serve the community best if
its
specialisation was not specifically in pump therapy, but rather in all
aspects of "intensified insulin therapy". You may choose to get your
basal
rate by 3 or more smaller injections of long acting insulin, and meal
boluses, geared to what you are eating, by injecting Humalog. Or you may
choose to do the whole thing by pump. Frequent injections of long acting
insulin is a nice solution, since it smoothes out the potential peaks
and
troughs of once or twice daily long acting insulin.

Edwin Gale, head of diabetes care in the Bristol area, talked to me a
couple a years ago about setting up a clinic for intensified insulin
therapy. I've no idea what has come of his plan. It would be both for
pumpers and people on flexible insulin therapy - where you match the
insulin to what you are eating.

Di was telling me - very revealingly - about a colleague of hers at work
who has Type 1 diabetes, and never tests "because it hurts and there's
no
point". This guy is not stupid, and has several degrees behind him, and
works on an advanced research project. And if the late morning meeting
overruns, he gets rather shifty because he's late for his lunch, and at
the
office barbeque he could only eat one sausage "because it was the wrong
time of the day". We have to respect his own choices. He's seen Di's
pump,
and isn't interested. But I do wonder what prompts him to accept these
restrictions on his life. Is it ignorance? Is it that no one at his
clinic
has empowered him to take control?

John



--
mailto:email @ redacted
http://www.webshowcase.net/johnneale


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