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From Liverpool, England:

I am a first year medical student currently studying diabetes as part of my course. Please could tell me if you believe there to be any inequality within the 'system'? By 'system' I mean the processes of referral to diabetes clinics, waiting lists, resources (injection pens, free glasses), treatment. For example, sons/daughters of doctors/consultants. Is every patient treated with exactly the same procedure? Any information in this area would be most useful.


Writing personally as a doctor working in the UK, I do not treat people specially because of their background, and I don't know of anyone who would. All of our patients are treated


Additional comments from Dr. Stuart Brink:

Nobody is treated the same even in the same countries since medicine is an art and not a science. This applies to diabetes care as well although there are many textbooks as well as treatment guidelines. Consensus Guidelines for the Management of Insulin-Dependent Diabetes in Childhood and Adolescence 2000 from ISPAD is a good consensus document. ADA guidelines [The ADA's Clinical Practice Recommendations for 2001 are available at -- Ed.] as well as IDF Guidelines to Type 1 diabetes and IDF Guidelines to Type 2 diabetes, Australia, Canada and UK all have excellent guidelines as well. Treatment philosophy of the physicians and other diabetes team members counts incredibly.

Referral is likewise extremely biased. Physicians get different referral options and each country system, HMO or state-run system, has its own set of biases. Financial capabilities, transportation capabilities and just access to information all count for not only cost of care but also what care is provided -- living in the capitol city of a country or region matters, closeness to medical centers and university centers matters vs rural clinics.


Original posting 27 Nov 2001
Posted to Community Resources


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Last Updated: Tuesday April 06, 2010 15:09:28
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