Free Report on the Hypoglycemia Debate
And the hypoglycemia debate goes on with Schade et al picking up where we left off. They investigated thirty patients using a diagnostic algorithm. Here they measured the hypoglycemic response to a normal insulin dose both subcutaneously and intravenously.
The above test did not consider whether the subject was insulin resistant or that there was interference with treatment. They found out that twenty-eight of thirty patients were normally sensitive to insulin. They eventually explained the hypoglycemia problem as a result of the patients concealing this information from the researchers whether deliberately or involuntarily.
The above finding was supported by the Newcastle group who reported that of thirty three referrals, fourteen where either due to therapeutic error or psychological. They said further that of the remaining nineteen, half were known to have interfered with their treatment.
Gil et al also said that the aforementioned girls started by interfering with their treatment due to emotional stress. When the insulin doses soared, they continued being deceitful. The admissions continued thus completing the vicious cycle. And so it continues to persistent hypoglycemia volatility.
The trouble with this scenario is that many patients were seriously ill. Their episode of extreme insulin resistance when they were so ill would have made it impossible to interfere with their own treatment. And so they can’t be the cause of their hypoglycemia problem.
Doctors have missed this as a factitious disease for several reasons. One, they have been led to believe in the condition called idiopathic brittle disease. Second, they are unwilling to believe that the patients will deliberately mislead them and third, they are afraid to miss an organic disease.
With the discovery that the patient’s brittle diabetes disease as factitious come discomfort in the ward. To think that the patient has lied is difficult to accept but this is not helpful to both the patient and the doctor.
It is more important that with the correct diagnosis comes appropriate therapeutic plan. Anyway, psychiatric evaluation will show that the patient has been driven to such negative behavior by family and personal stress.
Review hypoglycemia research.
Or Brittle Diabetes Treatment?
It is best now to start with treatment regimen to solve the hypoglycemia problem. Perhaps psychiatric help will be needed but the central figure in the treatment should be the diabetologist because separating the physical and emotional problem will only cause confusion.
Everyone must know that there can’t be a neat solution. The treatment will be long-drawn-out. The treatment cannot be successful without everyone’s help. The patient, the doctor family and friends must all cooperate in the process.
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