NON-EVIDENCE-BASED CONCEPTS ARE STILL ESTABLISHED IN THE TREATMENT OFIDDM

Medicine is and always has been full of unproven concepts. However, wh en they are frequently used in clinical practice, they seem establishe d and are therefore seldom questioned. In his book 'Follies and fallac ies in medicine' (Glasgow, The Tarragon Press, 1989)Peter Skrabanek cl early proposed a way to improve the quality of medicine by being chron ically sceptical towards all 'established' concepts. By cyting Bertold Brecht he proposed 'scepticemia' as a major tool to speed up the prog ress 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 wis dom 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 diabet es therapy diet, exercise and insulin - with regard to their efficacy in reaching the goals of treatment in type 1 (insulin-dependent) diabe tes.