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      Non-Evidence-Based Concepts Are Still Established in the Treatment of IDDM

      , ,

      Hormone Research in Paediatrics

      S. Karger AG

      IDDM, Insulin treatment, Exercise, Diet

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          Medicine is and always has been full of unproven concepts. However, when they are frequently used in clinical practice, they seem established and are therefore seldom questioned. In his book ‘Follies and fallacies in medicine’ (Glasgow, The Tarragon Press, 1989) Peter Skrabanek clearly proposed a way to improve the quality of medicine by being chronically sceptical towards all ‘established’ concepts. By cyting Bertold Brecht he proposed ‘scepticemia’ as a major tool to speed up the progress in medicine: ‘The chief cause of poverty in science is imaginary wealth. The chief aim of science is not to open a door to infinite wisdom but to set a limit to infinite error.’ In this article we will try to analyze the evidence of the three so-called cornerstones of diabetes therapy – diet, exercise and insulin – with regard to their efficacy in reaching the goals of treatment in type 1 (insulin-dependent) diabetes.

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          Most cited references 2

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          Acute complications associated with insulin infusion pump therapy. Report of experience with 161 patients.

          We determined the frequency of acute complications associated with insulin pump therapy in 161 insulin-dependent patients followed up for a total of 2,978 patient-months. Diabetes control improved substantively with pump therapy, but 42% of the patients experienced one or more acute complications while using insulin pumps. Infected infusion sites, ketoacidosis, and hypoglycemic coma occurred once in every 27, 78, and 175 patient-months, respectively. More patients experienced ketoacidosis after the onset of pump therapy than in an equivalent interval immediately before the onset of pump therapy. Ketoacidosis also occurred in more patients using pump therapy than in a comparison group of 165 patients receiving conventional insulin injections surveyed during an equivalent period. The frequency of hypoglycemic coma was not significantly changed by pump therapy.
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            Ice cream in the diet of insulin-dependent diabetic patients

             D. G. Nathan (1984)

              Author and article information

              Horm Res Paediatr
              Hormone Research in Paediatrics
              S. Karger AG
              July 1998
              17 November 2004
              : 50
              : Suppl 1
              : 74-78
              Department of Metabolic Diseases and Nutrition, WHO Collaborating Centre for Diabetes, Heinrich-Heine-University Düsseldorf, Germany
              53109 Horm Res 1998;50(suppl 1):74–78
              © 1998 S. Karger AG, Basel

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              Page count
              Pages: 5
              Approaches to Better Care


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