Letters to the Editor

March 2005

Mar 1, 2005

Readers Chime In On Diabetes Busts’ Article

In my opinion, the U.S. healthcare system and many doctors collectively are the biggest busts in diabetes care and treatment. If I don’t take insulin, I die. However, insulin prices and my healthcare costs go up by double-digit percentages every year. My infusion sets and reservoirs cost more than $1,000 every three months.

Is there one general practitioner out there who can diagnose type 1 in someone over the age of 25? I, my brother and my father were all diagnosed over this age—myself at the age of 35. I nearly died, running BGs over 600, and the third doctor I saw at an urgent care clinic finally gave me insulin. They were certain that I was type 2 because of my age.

In my high-ketone haze, I remember a nurse saying, “You must have lost a lot of weight.” I will never forget that insult to type 1s everywhere.

I know of two others who also had problems with late-onset diagnosis. One person I went to high school with had a doctor who wouldn’t believe that a 32-year-old could be type 1, even after a C-peptide test.

And why do I have to see a doctor and pay for the visit and expensive blood tests in order to get a prescription for insulin? I know more about managing type 1 than any doctor I’ve seen, because I live with it every day and learn about it every day.

This system is not working and our government doesn’t care because we are the highest profit margin in any industry. That’s the biggest diabetes bust!

Derek Ryter
Lincoln, Nebraska

Placing the ADA Exchange Diet at the top of your list of “17 Biggest Diabetes Busts” (January 2005) is like declaring all cars unsafe at any speed. The ADA exchanges are not a “diet” but a vehicle to monitor portions and to illustrate comparable food substitutions in a meal plan that should be individualized.

Granted the exchanges don’t distinguish the “better” carbs (in whole grains, legumes, vegetables, fruits and low-fat dairy) from less-wholesome sources, but one can operate this vehicle wisely. One can choose the better options and use the exchange lists to follow either a low- or a high-carbohydrate diet. For type 2 diabetes, it’s not the carbs but the total calories that are most important, anyway.

Robin Edelman MS, RD, CDE
Diabetes Program Administrator
Vermont Department of Health
Burlington, Vermont

Editor’s note: For the “Diabetes Busts” article, busts were listed alphabetically.

Skin Care Article Was Only Skin Deep

As a type 1 diabetic, I read with interest your article on skin care (“A Dermatologist Gives the Skinny on Good Skin Care”, January 2005).

I was disappointed, however, that there was no mention of dermatitis herpetiformis (DH) in the article. DH is an extremely itchy rash typically found on the elbows, knees, hairline or buttocks and is a direct result of the ingestion of gluten in the diet.

DH is often misdiagnosed as eczema, but it does not respond to treatments typically associated with eczema. What most people don’t know is that if they have one autoimmune disorder, their chances of developing a second autoimmune disorder increases greatly.

Celiac disease and dermatitis herpetiformis are two disorders that often go hand-in-hand with diabetes, and with DH being a skin reaction to the ingestion of gluten, I would have hoped a mention of DH would have been made in the article. Unfortunately, most physicians in the United States are painfully behind the times in diagnosing DH and celiac disease.

Keep up the good work, and please consider doing an article on the relationship of diabetes with other autoimmune diseases.

Gary Youngberg
Ames, Iowa

Web Site Correction for Lancing Device Article

Your article “Choosing the Right Lancing Device” (December 2004) was most appreciated. However, there is one minor correction.

In the article’s reference table, you stated that the Accu-Chek Web site is www.roche.com, yet all of the other manufacturer’s Web sites were directly tied to their product Web sites. The Web site for Accu-Chek products and services can be found at www.accu-check.com.

Joel Reuter
Office of Public Affairs
Roche Diagnostics Corporation
Indianapolis, Indiana

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Mar 1, 2005

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