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DIABETES 2 INSULIN QUESTION
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<blockquote data-quote="Jenny15" data-source="post: 1799202" data-attributes="member: 196992"><p>I agree with you, I wasn't trying to challenge what you said, just adding the issue of LADA and other types in for the benefit of readers who may be unfamiliar with that issue. As you probably know, often someone with LADA is treated as if they have T2, delaying treatment that will be more effective for them and prevent complications sooner. </p><p></p><p>I read a post here last night from someone whose A1c has been above 70 for two years because she was not given the right care or advice by her doctors and didn't know the information was out there, including this forum. She now has painful and potentially irreversible complications. </p><p></p><p>The route to insulin often is quite slow for those who really need it, and (speaking in general, not about your post in particular) if people believe T2s should not have insulin, then the journey is even slower than it should be for those people. </p><p></p><p>I totally agree with you here "Personally, I would much prefer that my healthcare be delivered dynamically, based on advice from those with up-to-date, relevant expertise, than a static decision tree written at distance by someone who may not have any experience of diabetes." </p><p></p><p>My own GP ticks all those boxes in terms of dynamic, up to date care. The 3 levels of intensification in the NICE guidelines aren't meant to be used as a static decision tree, and they were written by diabetes specialist endocrinologists. Draft guidelines are pored over by doctors and any other interested parties before being finalised. </p><p></p><p>I'm not defending every assertion made in the guidelines, because I haven't read them all in detail and I lack the expertise to even understand some of them. I realize drugmakers and others have a disproportionate influence on guidelines, which is bad for patients and taxpayers alike. But that is a separate issue IMHO.</p></blockquote><p></p>
[QUOTE="Jenny15, post: 1799202, member: 196992"] I agree with you, I wasn't trying to challenge what you said, just adding the issue of LADA and other types in for the benefit of readers who may be unfamiliar with that issue. As you probably know, often someone with LADA is treated as if they have T2, delaying treatment that will be more effective for them and prevent complications sooner. I read a post here last night from someone whose A1c has been above 70 for two years because she was not given the right care or advice by her doctors and didn't know the information was out there, including this forum. She now has painful and potentially irreversible complications. The route to insulin often is quite slow for those who really need it, and (speaking in general, not about your post in particular) if people believe T2s should not have insulin, then the journey is even slower than it should be for those people. I totally agree with you here "Personally, I would much prefer that my healthcare be delivered dynamically, based on advice from those with up-to-date, relevant expertise, than a static decision tree written at distance by someone who may not have any experience of diabetes." My own GP ticks all those boxes in terms of dynamic, up to date care. The 3 levels of intensification in the NICE guidelines aren't meant to be used as a static decision tree, and they were written by diabetes specialist endocrinologists. Draft guidelines are pored over by doctors and any other interested parties before being finalised. I'm not defending every assertion made in the guidelines, because I haven't read them all in detail and I lack the expertise to even understand some of them. I realize drugmakers and others have a disproportionate influence on guidelines, which is bad for patients and taxpayers alike. But that is a separate issue IMHO. [/QUOTE]
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