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RE: [IPk] Rant: Lack of basic diabetes knowledge


> Aside from pitiful ignorance among 'experts' re pumps, Heather's e-mail
> reported, "The dietician was quick to denounce carbohydrate
> counting saying
> 'it doesn't work'." The glycaemic index still works better for
> some people
> than for others, but if I _ever_ meet a dietician who tells me that carb
> counting is useless, I will scream and shout until he/she
> believes that it
> is the only way forward. (No kidding.)

I just don't understand this either.  Maybe they mean that carb counting
doesn't work because people cant be bothered to do it rather than that it
doesn't work full stop.  I find that with Sasha the amount of carbs has more
effect than the glycaemic index.

> Rant item 1) It seems to me that the NHS has a REAL problem with
> the concept
> of self-management. Diabetes would cost the NHS a lot less (in time and
> money) if people with diabetes got enough education and support to _take
> care of themselves_ properly. I would seek help if I didn't know why my
> HbA1c came back high. However, I don't regularly need a lot of advice (I
> lowered my HbA1c by a point earlier this year by myself). My independence
> saves the NHS an appointment or two, or even a hospital stay, no?

I wonder if they haven't got the time to devote to explaining things to
people, but they should have.

> Rant item 2) I have been surprised and dismayed to see on this listserv
> questions about physiology and basic diabetes facts which I would
> have been
> able to answer within 6 months of my diagnosis, especially from people
> who've had diabetes much longer than I. How people can stay
> alive, much less
> avoid complications, without knowing the answers to some of them (for
> example: what causes diabetes, what factors other than 'sugar' can affect
> blood sugar, the long-term downsides of injections) astounds me.

I don't want to defend what seems to be a poor service to many people with
diabetes, but there is such a lot to take in at the time maybe people are
told but don't always take it in at the time.  Maybe there should be follow
up educational visits.

> Rant item 3) After doing it for about 7 years--less time than
> many people on
> the listserv--I think carbohydrate counting beats the American Diabetes
> Association's 'exchange plan' hands-down. The exchange system is too
> simplistic and not flexible enough for most people who eat (i.e.,
> everyone).

Most the parents on the childrens with diabetes parents support list seem to
use carb counting rather than exchanges, but then many of them pump.

I think I would have to give Lentil soup a miss for carb counting it sounds
very complex :-)

The other thing about the paediatric nurse that I spoke to, when she was
going on about how many problems they could bring, I said that I knew of
lots of children, some very young, using pumps in the US and she just
dismissed it with "well of course the health care system with all their
private medical system is different"  well that's not saying that pumps
don't work, its saying that we don't have the back up to use them here.

> Rant item 4) I think Julian might have hit on something about why the NHS
> won't go for pumps. Rather than rely on the bloody *research*
> that has led
> many major private insurers in the US to approve coverage for pumps--the
> research that shows that complications are more expensive than pumps, for
> example ('an ounce of prevention...'), the NHS is happy to look at the
> sticker price and say, 'Too expensive', and then look for (/spend money
> inventing?) reasons why something that has been shown to work around the
> world just won't work in Britain. I could start on the chicken
> pox vaccine
> and autism thing, but I won't.

What annoys me that even if you are prepared to pay for your pumps you meet
negativity at every turn and what really pees me off is that the very people
who are negative don't really know much about pumps at all.

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