I also know a couple of cases that have abandoned the bomb ... also teenagers.
In the same way that there are still patients who use traditional roads and syringes instead of feathers ... each is a world.
As for the debate (interesting by the way), the bomb does not improve yes or yes, as Gondrullo says.
Who improves is the patient ... If the patient does not learn to count hydrates correctly, to calculate the bolus according to the situation and suggestion of the pump, to reformulate the basal according to results, to know how to take advantage of the dual bolus and use theTemporary basal according to events ... The pump will not improve at all, which is still a traditional dropper equipped with an electronic diffusion system and a calculator that uses parameters that must be modified.
And here is the key, in my opinion, of the matter ... the issue is not the legal requirements for the granting of bombs but the individual capacity of each patient to change the dynamics in which it was before the bomb (including theNeed to make a minimum of 5-6 glycemia controls per day), be able to assume the new (or forgotten) concepts of diabetological education and to be able to take the right to a complex instrument such as insulin pump.And of course the psychological variable, so many times forgotten.
Because legal requirements are a joke, they are celebrated by 95% of type 1 patients:
- Multiple injections regime: at least three daily, and that have required frequent self -support of the insulin dose.
And that they are in any of these situations, note that the BOE puts some, not all.
- glycosylated hemoglobin & GT;7.0%.
- history of recurrent hypoglycemia .Recurrent in what sense ???daily?weekly?Do we include hypos by exercise or only the "uncontrollable"?
- Wide variations in preprandial blood glucose. It would be necessary to define broad ... and to what limit ... but come on, weird is the person who does not have variations of 50 or 60 mg/dl minimum ... taking into account that it puts preprandial, does not speak ofBasal glycemia.
- Alba phenomenon with glycemia that exceed 200 mg/dl.
- History of severe glycemic deviations.
These requirements forget cases such as gastroparesia, labile diabetes, from phobia to needles ... or trained medical personnel for the establishment and monitoring of bombs: Twisted:
What Clinidiabet says: Improving adherence to treatment is the key to pump therapy.
It is said that by avoiding 2 severe/year hypoglycemia (requiring medical assistance: ambulatory or hospitable) ISCI is already effective cost.
I leave a link on a cost study of insulin pumps: Link ... ci_arttext >
whose conclusions are: The improvement in glycemic control in patients with bike was associated with a reduction in the global cost of the management of patients with DM1, and it turned out to have a favorable cost-utility relationship when comparing it with conventional MDI treatment.
Because as we have already commented many times in this forum, the diabetes costs shoot at complications and not for prevention.
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