LETTERS TO THE E D I T O R

Letters on any aspect of diabetes care are welcomed and should be addressed to the Editor

Community lancer device problem Sir, As a Diabetes Liaison Nurse working within the community setting, I have come across a problem and would value any ideas on how to solve it.

District nurses tend to visit diabetic patients who cannot maintain their own monitoring and insulin requirements. Although patients hold their own lancer devices (usually Glucolet 1 or Soft-touchLancers) there could be a sharps problem when the nurse unloads the lancer after use. In addition, removal of needles after using an insulin pen device could also be a source of injury.

Sixteen per cent of sharps injuries were caused by such devices in my NHS Trust in 1996/1997.

Some devices, such as Glucolet 2 and Softclix, have a covered lancet which ensures the needle is not exposed. However, the lancets retail betweenfl1.54andf15.33 for200andarenotonFPlO. This would incur considerable cost (each nurse would need her own supply) for which there is currently no budget in my Trust.

The alternative BD Safe-clip device truncates and retains the sharp from syringe needles. However, this device is not currently authorised for use with blood lancets.

If anyone has actually solved this problem, or has an idea of how I can solve it, I would be grateful if you could contact me at my address below:

JULIE ALLISON, Diabetes Liaison Sister, West Acklam Clinic. Birtley Avenue, Acklam, Middlesbrough, Cleveland, UK (Tel:01642813568)

Paucity of resources in Africa Sir, I read with interest the article ‘Diabetes care in Africa: health or wealth?’ in your May issue of Practical Diabetes International (Vol. 14 No.3,1997).

where I visited a friend working as a Paediatsic Consultant in Blantyre. The Paediatric Department there is continually fighting for resources and funds.

diabetes was brought in with ketoacidosis. She was stabilised over the next few days and by the Monday was ready to go home. However, a last-minute problem arose - the hospital had completely run out of

I thought I would write and share a recent experience I had in Malawi,

While I was there a nine year old girl with known insulin-dependent

insulin! The girl’s family had no further supplies so she was kept in hospital, nobody really knowing what the outcome would be. Fortunately, two days later, new insulin supplies arrived and the little girl was able to go home.

A happy ending this time, but it was a lesson to me on how huge a problem lack of resources is in Malawi. Even when adequate funds were available there seemed to be no guarantee the medications would arrive. Without the resources, the health professionals were, in this case, rendered helpless.

live near enough to healthcare facilities for it to be available to them. Even these few cannot be guaranteed a continuous supply of insulin.

PENNY BRIlT, Senior Dietitian, St Richard’s Hospital, Chichester. UK

In Malawi only relatively few people can afford insulin treatment, or

How much we in the Western world take for granted!

The Diabetes and Hypoglycaemia Forum on CompuServe Sir, The Diabetes and Hypoglycaemia Forum on CompuServe had their second SilverlGray Ribbon Day on 13 November last year. The campaign was launched to educate the public about the devastating nature of diabetes and the desperate need for a cure. The Juvenile Diabetes Foundation International, amongst other activists, have joined the campaign. The campaign belongs to the whole community and is not intended to produce profits of any kind.

The Diabetes and Hypoglycaemia Forum on CompuServe (GO DIABETES) was founded in 1989 by David Groves, a Type 1 diabetic since age eight. Its objectives are its motto: Educate, Motivate, Activate. More information about the campaign can be found on this forum and at the following web sites:

http://tenbrooks 1 1 .lanminds.com/ http:l/www.traders.co.uWinsulintrust/ http://www,geocities.com/HotSpringsl8080 http:llwww.geocities.com/-curenow http://www.members.tripod.cod-drarlenes/index.html

Thank you for giving us the opportunity to make this information more widespread via your journal.

WILMA REIBER, Belmont, California, USA (E-mail: reiber@compuserve.com)

NOTICE

Meeting of the Association of British Clinical Diabetologists (ABCD) Copthorne Tara Hotel, Scarsdale Place, Kensington, London, UK

Thursday evening and all day Friday - 30 ApriV1 May, 1998 There will be presentations on:

The future of diabetes care; 0 Polycystic ovarian syndrome and insulin resistance; 0 Business planning and diabetes services; 0 The EUCLID Study;

0 Debate on lipid-lowering in Type 2 diabetes- the case for and against intensive lipid-lowering therapy Details maybe obtained from:

Dr Richard Greenwood, ABCD Secretary, Norfolkand Norwlch Hospital, Brunswick Road, Nomich NR13SR Tel: +44 (0)1603 286 769 Fax: +44 (0)1603 287 320

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Practical Diabetes International MarcWApril1998 Vol. I5 No. 2 61