Letters to the Editor
Take a Look Back
I liked your survey article on neuropathy and would like to see more like it in future issues. However, it seems to me that you drew excessively on one source (Aaron Vinik, MD, PhD). In particular, the comments on impotence could be interpreted to mean all hope is lost for those who don't seek out a neuropathy expert within six months of diagnoses. The current publicity accompanying the introduction of Viagra, and the test results for that drug (including treatment success rates for diabetic men) suggest there is more that can be told along these lines. I, for one, would appreciate your directing your considerable talents in that direction.
In my opinion, you still have the best publication in the field for consumers. Every now and then you might look back at your landmark issues of the early '90s.
Thanks for being there.
Something for the Old and the Young
You publish a great publication. My 11-year-old daughter with diabetes loved the picture of the bloodless Glucometer in the works by Cell Robotics!
Geralyn da Silva, RN
Try This On Anything But Lispro
I have to respond to a Research Update, "Is Lispro Bad for Babies?" in the March issue with an emphatic NO! I went on Lispro two weeks into my pregnancy last year, and because of it and pump therapy, I lowered my HbA1c to below 6, and kept it there for the duration of my pregnancy. I delivered a perfect baby girl last June, at a perfect 7 pounds 12 ounces.
My doctors told me to keep my blood sugars between 60 and 90 during my pregnancy, as pregnant women apparently have lower blood sugars than normal. Try that on anything but Lispro and pump therapy! I tested every two hours around the clock. Lispro allowed me to give myself multiple boluses throughout the day and night as needed to bring down "highs" of 130, without suffering the cumulative effect I would have had using Humulin Regular.
I haven't read the New England Journal of Medicine article upon which the Research Update was based, but to not use Lispro on the basis of two women losing their babies seems absurd. This number seems statistically insignificant under any circumstances. Any number of confounding variables could have caused birth defects.
Let's Hear More About the Elderly
In late 1997 there appeared to be a growing advocacy concerning older persons who acquired insulin-dependent type 2 diabetes in their 60s and 70s, the contention of the movement being that they should not have to undergo intensive, invasive and very costly insulin and blood testing therapy because only one in 100 would develop any of the major complications of diabetes before they die.
But I have not seen any articles regarding this advocacy in your excellent magazine, and, therefore, would ask that you please research and publish a detailed article on this subject.
Mountain View, Calif.
Editors' Reply - DIABETES HEALTH has a feature article on the special concerns for seniors with diabetes in the works. Keep an eye out for it in the near future.
Narrowing the Gap and Broadening Horizons
I just wanted you to know how much I learn from and appreciate your magazine. I have just visited one of the web sites published in your last issue (www.castleweb.com/diabetes/ - the website dedicated to children with diabetes). Thank you for decreasing the distance between persons with diabetes and increasing the awareness of, and providing education on, diabetes for all people.
Kim Lobree, RN, CDE
A Little Perspective
I have been exchanging messages for a couple of months with Nestor Loreto in Buenos Aires, Argentina. He is 32 years old and has been a type I for 17 years.
In his country, the law provides for three syringes for a 90-day period, 30 test strips for 90 days, and extremely high-priced insulin: $46 a vial, second highest in the world only to Japan. He estimates his average monthly expenses for diabetes care to be about $240. From his last letter, it seems he is now in a great deal of trouble with his government after appearing on TV to criticize the government policy toward diabetics. His phone is tapped, and he and his wife and son have been threatened.
Argentina is infamous for its desaparecidos, the disappeared, who are never heard of again after they are arrested. He is truly afraid this could be his fate. People with diabetes who are arrested are not allowed to call anyone to get a supply of insulin. Others are refused jobs or health insurance by their employers, and type Is cannot get insurance coverage at all. Beef insulin is being removed from the market despite protests, and with government permission.
We may think we are having a hard time with our diabetes, and no doubt many of us are. Still we are one hell of a lot better off than in some other countries.
If anyone would like to send an e-mail of support to Nestor, preferably in Spanish, his address is firstname.lastname@example.org
DIABETES HEALTH received good news on Nestor Loreto just before publication. Martin McArthur recently wrote:
Far from being "disappeared" Loreto's appearance on television has crystallized action in his country that no one expected. He has been barraged with telephone calls and been invited as a guest on several other nationwide television shows. He has also been asked to help draft a law that will free diabetics from the fear of ill treatment. One person can truly accomplish something!
In Need of A Wake-Up Call
After reading several articles in the March edition of your newspaper, I was quite annoyed to read and repeatedly hear of the struggles of so many of the victims of diabetes, not only from the illness, but from bureaucratic red tape.
For instance, in the state of California we have a governor who seems to give little validation to the insidious and continually destructive nature of this illness demonstrated by his veto of the legislative bill SB1220 (Management and Treatment of Diabetes), even though this bill passed the Senate 24 to 11 and the Assembly 58 to 18.
I wonder what our governor, Mr. Pete Wilson, would have done if the surgery he had for his throat condition was not on the program or in the budget? Perhaps he could teach himself sign language. As far as phone calls, he might be allotted some limited assistance only if these were deemed necessary by a government employee of course. Maybe then he would have a wake-up call.
Teres B. Soja