The homework
Well, let us get back to our efforts to get Emilie started on the insulin pump. As you might understand, the driving force was the knowledge we could gather by ourselves. The pump was not a suggestion made by our diabetes care providers. As a part of our ‘research’ we had – among other books – read the Swedish endocrinologist and child physician Ragnar Hanas’ excellent book ‘Insulin-dependent Diabetes in Children, Adolescents and Adults – How to become an expert on your own diabetes’ which also covers CSII.
But the book that became almost a ‘bible’ in our preparations for pump therapy was ‘Pumping Insulin – Everything You Need For Success With An Insulin Pump’ by John Walsh and Ruth Roberts. Systematically it guides the reader through every bit of the road towards successful pump therapy. From initial considerations via calculations of initial doses and start-up to very specialized chapters on elite sports, pregnancy and children.
It is a very systematic and methodical book. The writers are very fond of tables and formulas. But everything is based on practical experience. And our experience is, that the guidance given in this book really is trustworthy.
In our preparations, we also had contact with the Danish representatives of the pump manufacturers. Or, rather, representative because at that time only MiniMed was present in Denmark. But we also approached what was at that time Disetronic via their U.S. website. From there our mail was directed via the Swiss head office to the Swedish representative who one day called us.
We had a long and very inspiring conversation that became more conversations and finally an offer that would make it easier for us to convince our hospital to put Emilie on pump therapy: Disetronic would supply the pump and supplies to the hospital, if we would share our experiences with their newly established office in Denmark.
The chief physician at our clinic at that time had been very reluctant to comply with our wish to get Emilie on pump therapy. In his opinion, there was a lack of evidence as to the benefits of CSII in children – which was at least at that time not entirely wrong. But he was immune to our arguments that in the treatment of children other parameters than HbA1c counted and that clinical experience in our neighbouring countries showed results that could justify at least trying it.
Today, another physician – Birthe Olsen – is head of the children’s department, and she is one of the leading forces among Danish endocrinologists working to promote the use of pump therapy in children with diabetes in Denmark. Her department at the Glostrup County hospital with 330 children is the largest centre for children with diabetes in Denmark. Today between 20 and 30 of these children are using an insulin pump. And that number is expected to rise significantly in the years to come.
This is the fifth post in a series - read the first post here.
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