Re: Continuous subcutaneous insulin infusion versus multiple daily injection regimens in children and young people at diagnosis of type 1 diabetes: pragmatic randomised controlled trial and economic evaluation
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Continuous subcutaneous insulin infusion versus multiple daily injection regimens in children and young people at diagnosis of type 1 diabetes: pragmatic randomised controlled trial and economic evaluation
Re: Continuous subcutaneous insulin infusion versus multiple daily injection regimens in children and young people at diagnosis of type 1 diabetes: pragmatic randomised controlled trial and economic evaluation
8 April 2019
Dear Editor,
I have just read your article “ Continuous subcutaneous insulin infusion versus multiple daily injection regimens in children and young people at diagnosis of type 1 diabetes: pragmatic randomised controlled trial and economic evaluation” - BMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l1226 (Published 03 April 2019)
I note that the sample was restricted to young people so I hope the conclusion that the CSII cost is not justified will not be read across too widely. I write to give my experience as an example of other factors which can make a great difference to long term health and the ability of patients to contribute to society and as tax payers.
I started using an insulin pump (CSII) around the same time that I became a barrister, and after having used bolus and basal injections for about 20 years (including an early period without bolus but just 2 injections a day).
Before using CSII I could not cycle or go on long walks without having hypos, treated with sugar, every 10 minutes. It made such activities anti-social and infrequent. Also, when I argue cases in court my blood sugar goes up so much that, prior to having a pump, I had to leave hearings so that I could vomit.
With the CSII I know to increase my basal rate to 150% for all hearings, and some meetings, and I can function as well as if I was not diabetic. Similarly, if I want to cycle or go on a long walk I reduce my basal rate to 20% or sometimes lower.
I am now much more active, very rarely get sick, and am contributing to society and the public purse. I’m sure that others on pumps enjoy similar benefits, so I hope these aspects will be borne in mind by any decision makers in relation to the funding of CSII.
Rapid Response:
Re: Continuous subcutaneous insulin infusion versus multiple daily injection regimens in children and young people at diagnosis of type 1 diabetes: pragmatic randomised controlled trial and economic evaluation
8 April 2019
Dear Editor,
I have just read your article “ Continuous subcutaneous insulin infusion versus multiple daily injection regimens in children and young people at diagnosis of type 1 diabetes: pragmatic randomised controlled trial and economic evaluation” - BMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l1226 (Published 03 April 2019)
I note that the sample was restricted to young people so I hope the conclusion that the CSII cost is not justified will not be read across too widely. I write to give my experience as an example of other factors which can make a great difference to long term health and the ability of patients to contribute to society and as tax payers.
I started using an insulin pump (CSII) around the same time that I became a barrister, and after having used bolus and basal injections for about 20 years (including an early period without bolus but just 2 injections a day).
Before using CSII I could not cycle or go on long walks without having hypos, treated with sugar, every 10 minutes. It made such activities anti-social and infrequent. Also, when I argue cases in court my blood sugar goes up so much that, prior to having a pump, I had to leave hearings so that I could vomit.
With the CSII I know to increase my basal rate to 150% for all hearings, and some meetings, and I can function as well as if I was not diabetic. Similarly, if I want to cycle or go on a long walk I reduce my basal rate to 20% or sometimes lower.
I am now much more active, very rarely get sick, and am contributing to society and the public purse. I’m sure that others on pumps enjoy similar benefits, so I hope these aspects will be borne in mind by any decision makers in relation to the funding of CSII.
Yours sincerely,
Georgina Hirsch
Competing interests: No competing interests