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Posted by klausen on 17:30:11 2004/02/29
In Reply to: Re: Sick Child Tips the Balance for Parents posted by Alan F. Bachrach, M.D.
I understand that these parents mean well, but a child needs to be free, and all this testing, poking, prodding, fretting, measuring, and injecting can't be very pleasant for the parents, their diabetic children, or the other children in the family.
Perhaps because there were no home blood sugar meters when I was growing up, the management of diabetic children was much more casual and allowed for a much more normal life. Diabetes was not much talked about in public, and neither my school nor my parents' employers knew about my condition. Even some of my friends and relatives were not informed of it. I always kept my condition a secret, and what little management of the disease I performed, I kept to myself. There were no interventions by the school nurse, interruptions of the school day, anguished calls back and forth to my parents' workplaces, disturbed sleep for multiple blood sugar tests, etc. And this freedom was not just characteristic of the way I lived, but of the way most diabetic children conducted their lives, as I knew from friends managed along with me through the Joslin Clinic in Boston.
I tend to view the matter in terms of game theory. If you let the blood sugar run high, don't have to worry about hypoglycemia, and live a full, free, spontaneous life, then if you are also lucky enough to avoid complications you have a 100% victory. But as soon as you decide to give up half the value of your life by imprisoning yourself within a program of intensive diabetes management, if you then also avoid complications your maximum victory is still only 50%. Obviously each patient will draw the balance between quality of life and complications differently, but I worry that the availability of easy ways to test blood sugar at home may have tipped the balance too much in favor of management and too little in favor of life.
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