Letters to the Editor
More Meter Talk
Last weekend I attended a diabetes seminar at the San Diego Convention Center. There was a large exhibit room displaying just about every type of diabetes paraphernalia you could imagine. At one of the exhibits, you could test your glucose meter's reading against the exhibitor's equipment. It was a relief for me to be able to do this because I have always wondered how accurate my meter is. From reading your article, this seems to be a concern of a lot of diabetics.
I have been using a One Touch II meter for 14 months now and my meter was off by only 3. Unfortunately, I don't know exactly what sort of equipment the exhibitors were using. Can you help me?
Answer: It was the Hemocue Glucose Analyzer by Hemocue, Inc. The company can be reached by calling (800) 323-1674.
Loran Controversy Continues
The following are part of a continuing discussion about Loran Medical Systems' $20,000 experimental trials involving fetal pancreatic tissue injections, reported in our October '95 issue.
Congratulations on a thorough and well researched piece about Loran Medical Systems.
This reminds me of the 'go to Mexico to get your cancer cured' concept. The message is the same: "For money, I'll solve your problem."
I have yet to see any unbiased studies of Mexican cancer treatment programs-only anecdotal stories, all positive of course. The same appears to be the case with this treatment.
One detail not mentioned: Where are the islets transplanted? Most methods I have heard about seem to place the islets (encapsulated) under the skin.
I'm one of the patients from the Sansum fetal islet cell transplants of August, 1993, and I can tell you that I experienced no change at all. I support Dr. Peterson and what he's trying to do, but there's no proof that the procedure really works. It simply isn't true that every single person involved in the trials experienced a 15% reduction in their insulin dosage. I didn't experience any reduction. I am making a very, very small amount of C Peptides, which I wasn't before the trial, but it's not enough to make any change in my insulin requirement.
I know that some of the other people involved in the Sansum trial experienced huge insulin requirement reductions right after the procedure but were right back to their original levels after a few months. When I participated in the trials, we were led to believe that the procedure was a potential cure. The doctors are currently more conservative in their claims.
Please contact me if you'd like any more information. $5,000 for the Sansum trials was one thing, but the $20,000 Loran is asking for this procedure is a total rip-off!
Control and Complications
(The following posting was in response to "Diabetic Complications from the Patient's Point of View" by Joan Hoover, published in our March 1995 issue. The article takes issue with the idea that it is possible to avoid diabetic complications by simply keeping normal blood glucose levels. Hoover argues that constant euglycemia is not an achievable goal for people with diabetes because uncontrollable physical and emotional stresses will invariably upset normal BGs no matter how conscientiously control is attempted. She points out that health professionals who don't undertand this often "blame the victim" for complications).
I fully agree with Joan Hoover, but would like to add a remark or two.
First, "constant euglycemia" or in plain English, "well-controlled BGs", in no way implies you do not get complications. Take my case: I tightly control my BGs (mean generally below 100 and HbA1c between 6.5 and 6.7) but suffer nevertheless from neuropathy of the lower part of the body. My doctor claimed that it would recede after I was put on insulin. That did not happen. So he said he thought I was 10 years younger! Of course he has all my data, certainly my age (I am 59), in my file.
Second, it is absolutely unbelievable how the medical profession will "blame the victim" for their inadequacy to prevent complications. I am told that in traditional Chinese medicine you pay your practitioner a certain amount of money yearly with the explicit proviso that he keep you healthy. If he failed he was paid nothing at all. This is an idea we could and should adopt.
The Chinese practitioner is a great idea, but what of the type I patient who lackadaisically takes care of himself? Would the practitioner have to show up for breakfast, lunch, dinner, and bedtime to check glucose and administer insulin? He would also have to be the person's personal physical fitness trainer. Not cheap. Just a thought. Some of us probably wouldn't mind this healthcare concept except for the price.
In response to Michel's statement that "it is absolutely unbelievable how the medical profession blames the victim for its inadequacy to prevent complications"-as a type 1, I must take issue with his statement.
Most diabetics I have talked with are lax about how they care for themselves. Most feel that any BG under 200 is a good one. When asked what books and publications they have read, the response is always the same-"none." Fortunately, there are some of us pancreatically-challenged who give a damn about educating ourselves about this killer disease.
The advances in the last 15 years are incredible. Look at the meters, pumps, and insulins recently made available to us. These will no doubt extend quality years to those of us who choose to take advantage of them. The unfortunate sufferers of diabetic complications did not have these tools (or now choose to not use them). Is this to be blamed on the doctor?
I look at doctors as being more like "guidance counselors." They cannot be with us 24 hours a day, feeding us and forcing good habits on us...that's our job! Self control and responsibility for our own actions are learned behaviors. Having pity parties and blaming the healthcare folks is just plain dumb. If you don't think you have a doctor who's giving you good treatment, move on, just as I have done. The doctors did not give us this disease, they're just trying to help us help ourselves.
I have been a diabetic for 25 years. Other than neuropathy, I'm doing pretty well. My A1Cs are usually 7 to 7.5. I've had 3 surgeries on my left foot, each one more serious but none of them horrible or terrible.
I recently found out that I have Charcot Foot. My first metatarsal slipped out of joint. I walked on it for a month without knowing it and now I'm on crutches. Since I'm under 40 years old and in relatively good health otherwise, my doctor is recommending doing a surgery where he will fuse the joint.
I'm going for a second and third opinion even though I do have a lot of confidence in my doctor. I would like to learn from anyone else's experience in this area.
I share the sadness over the no beef U issue. Back in 1980, a "radical" endo put me on beef U and regular for my busy lifestyle. That one act radically changed my perception about my diabetes (diagnosed in 1963). I was now in control instead of the insulin. My life truly changed. Even my husband, who left much of my diabetes management up to me, noticed a change in me. So, for 15 years things have been great.
I had my second child with the beef U and regular program, and every time I asked my doctor if I should try the pump, he replied, "It ain't broke, so don't try to fix it!"
Since I work for a diabetes supply company, I rounded up all the beef U I could find when the word broke. (I hoarded 6 bottles, that's all!) I have 2 left. I drain the bottles dry. The expiration date has passed, but it's still OK. I'm not excited about changing my regimen after 15 years, but I guess I'll have to. It's tough to teach an old dog like me new tricks. Have any of your readers seen a change in switching? I look forward to your comments.
Where's The New Insulin?
A few months (or more) ago, you wrote about two new products that should have been on the market by now. They were a long acting insulin (like Ultralente, only better) and a quick-acting insulin which worked within two or three minutes. What happened to them? They were to be produced by Eli Lilly Co. I've been anxiously waiting, but to no avail. Should I keep on waiting or will they never appear?
In your October 1995 issue was a story entitled "Group Calls for Insulin Manufacturers to Repackage Insulin." I would like to remind people that in the 1950's and 60's, NPH was in a tall (I think) square bottle. Globin (an insulin that is no longer manufactured) was a in a short, fat, square bottle. Why can't they do that now?
Virginia Beach, Va.
To answer your question about fast acting insulin-please see page 12 of our December issue.
We are not aware of any new long acting insulin, although we did write about animal Ultralente being pulled off the market one year ago. Many people were very disappointed to see this valuable tool lost. Click Here To View Or Post Comments