Pump or not to pump

[Vaper]

Hi, I have recently been confirmed type 1 after initially being diagnosed type 2, I have been forced off work by company doctor as my bg levels are too erratic for the last 4 months. Safety first on the railway. I'm seeing the hospital for my first appointment next week and I'm thinking I would like to move away from injections and on to a pump as I work both day and night shifts and would be able to keep in range easier and safer around the trains as I work at track level with the trains. Does anyone have experience of the pump or any advice please.

 

[azure]

Look at the Pump section here @Vaper I can move your post there if you would like as you may get more replies.

I have a pump and absolutely love it!

 

[Vaper]

Look at the Pump section here @Vaper I can move your post there if you would like as you may get more replies.

I have a pump and absolutely love it!

Yes please move my post to pump section

 

[azure]

Moved now @Vaper Have a read through the threads here and you'll see a number discussing the pros and cons of pumping.

Do you carb count and adjust your insulin? Thats important to understand if you want a pump.

My pump is an Animas Vibe. Let me tag some other pump users for you @Juicyj @noblehead @himtoo @catapillar @iHs There are many more too

 

[Vaper]

Moved now @Vaper Have a read through the threads here and you'll see a number discussing the pros and cons of pumping.

Do you carb count and adjust your insulin? Thats important to understand if you want a pump.

My pump is an Animas Vibe. Let me tag some other pump users for you @Juicyj @noblehead @himtoo @catapillar @iHs There are many more too

I will attend my first hospital appointment next week, I currently use humilin3 but assume things will change drastically next week, I need to be in full control as I cannot afford to go hypo at work due to the dangers with live rails and moving trains. Working 12hr day and night shifts also has its tolls as my body constantly has to adjust to when to consume food. Getting up at 4am I don't feel like food and staying awake all night makes eating patterns different. I'm thinking with a pump I can have better control and be safer not just as a diabetic but as a diabetic in a dangerous work place. Changing career is not an option. Do people agree this would be my best route of am I getting worked up over nothing.

 

[azure]

@Vaper Certainly a pump would make it easier for shift work. You can have different basal settings depending on your shift pattern, for example. You can also do more precise boluses eg 3.75 units instead of 4 units.

Some pumps - the Vibe and the Medtronic - also support a CGM (which you'd probably have to self fund) that will send blood sugar readings to,your pump.

I think a pump is well worth looking into if you're struggling because of your job.

Nothing to do with pumps, but I also recommend the book Think Like A Pancreas as it's a great book for Type 1s.

 

[Juicyj]

Hi @Vaper I'd agree a pump would help you manage better, however based on your current regime, a bolus/basal regime would also work very well too as it would give you greater control. Unfortunately whatever route you take hypos are inevitable, they go hand in hand with type 1 and insulin. If you go down the route of a pump then there is a period of adjustment with getting your ratios fine tuned and it does take a lot of work to get this right, yes your control can improve hugely, but I cannot comment on using a pump and shift work. Ideally a continuous glucose monitor would be a useful tool for you in your role as you could track patterns and see if you are going high/low, this would help give you information which could help stabilise your BG levels.

 

[himtoo]

Hi @Vaper
working shifts is not an easy road to follow being Type 1 diabetic - our bodies love a routine.

so a pump helps to overcome this by providing an artificial routine that you can create with basal settings on a pump.
I would recommend you look into this with your work regime

 

[genix]

Re your work @Vaper, insulin pumps use one type of insulin only, the fast acting kind, so you don't have long acting insulin working at random-ish times and so you can fine tune it a lot easier, this alone I personally found changed everything.

 

[catapillar]

Where are you based @Vaper ? It's pretty unusual /against guidelines for a newly diagnosed type 1 in the uk to be put on mixed insulin. Pumps use a basal/bolus regime, I expect you would have to be familiar with a basal/bolus regime before moving onto a pump - how to do basal testing, how to carb count, how to make insulin adjustments. An MDI basal/bolus regime would also give you more flexibility for shift work, something that a pump could probably fine tune, but I would see moving to a basal bolus regiem as the obvious first step

 

[azure]

Perhaps a hangover from the Type 2 misdiagnosis @catapillar ? As you say, mixed insulin is less flexible, and harder to adjust.

 

[noblehead]

Hi @Vaper and welcome to the forum

Certainly talks things through with your Consultant/DSN to see if they'll put your name forward for a insulin pump, if you take a look at the following it lists the NICE criteria & the ABCD recommendations for pump funding:

http://www.inputdiabetes.org.uk/alt-insulin-pumps/is-it-provided-by-the-nhs/

I need to be in full control as I cannot afford to go hypo at work due to the dangers with live rails and moving trains.

Many of us will vouch that you have fewer hypo's on a pump but a pump doesn't eradicate them altogether, so they'll always be a risk of hypo's no matter how well you are controlled.

Best wishes and good luck.

 

[Vaper]

Thank you all so much for your advice and experience, It is a constant worry with my work and sickness is monitored and persistent sickness can lead to parting company. As I also work under a safety critical licence having that removed would definitely spell the end of my career. I need the best form of control as a hypo would prevent me going track side for obvious reasons and as a manager that could definitely leave my staff in a unsupported position when situations arise, which they do every shift. I now know that I can't fully avoid hypos but to be able to monitor my levels constantly without strip testing every 10 mins (so to speak) when I need to walk the Depot to check and communicate with staff would be a God send.

 

[iHs]

@Vaper The art of using in insulin safely is in blood glucose monitoring every 2.5hrs and adjusting the carbohydrate correctly if using twice daily, and adjusting the insulin correctly using ratios ideally along with a correction factor.if using MDI or a pump

Pumps won't stop hypos but tend to make them milder. They do demand a lot of attention to get the quantity of carb correct to an exact gram before eating food in the early days so that the correct ratio can be found and not to use guesswork unless there is no other way like when eating food in restaurants etc. They also demand frequent bg testing during the night and the day to determine the correct basal rate for every time frame. MDI is not quite the same as a pump but involves ratios, correct factors none the less.

Cgm is now starting to make most people's lives a lot safer as target warnings can be set up on the receivers, mobile phones and pumps and by seeing how low a bg is going before being really low and being able to eat some food to elevate bg a bit so that people can carry on doing whatever and not need to sit down because they feel so wobbly etc.

 

[catapillar]

to be able to monitor my levels constantly without strip testing every 10 mins (so to speak) when I need to walk the Depot to check and communicate with staff would be a God send.

That's not what a pump does. That's what a CGM does. It's very unusual for a CGM to be NHS funded, but you can just buy them, no prescription required. Have a research into the various monitors (dexcom/enlite/libre) to see what might suit your needs/pocket.

 

[Vaper]

Thanks everyone it's so confusing at the moment, although I know the principle of keeping bg's in an acceptable range by controlling carb intake and insulin dosing there is just so much more to it and that's with out the side effects I suffer with high blood pressure,cholesterol and the pain in my feet and legs, hypers and hypos. After a year I'm just getting my head around having diabetes but getting my head around all the Meds, doses, foods, timings and equipment is enough for degree level.

 

[azure]

Try the book Think Like A a Pancreas. Also, speak to your team about changing to a basal/bolus regime which should give you more flexibility. It would also be good practice for a pump.

Yes, there's lots to learn, but friendly people here who can support you and know how overwhelming it can all be.

 

[Vaper]

Where are you based @Vaper ? It's pretty unusual /against guidelines for a newly diagnosed type 1 in the uk to be put on mixed insulin. Pumps use a basal/bolus regime, I expect you would have to be familiar with a basal/bolus regime before moving onto a pump - how to do basal testing, how to carb count, how to make insulin adjustments. An MDI basal/bolus regime would also give you more flexibility for shift work, something that a pump could probably fine tune, but I would see moving to a basal bolus regiem as the obvious first step

As hospital appointments take so long I'm still on my misdiagnosed type 2 insulin along with metformin, I was diagnosed diabetic a year ago due to unable to stabalise bg, I was given a gad65 blood test and put on the insulin. Gad results came back as 67 and was then passed to the hospital. My first type1 hospital visit is tomorrow when I assume it will be all change.

 

[Vaper]

Try the book Think Like A a Pancreas. Also, speak to your team about changing to a basal/bolus regime which should give you more flexibility. It would also be good practice for a pump.

Yes, there's lots to learn, but friendly people here who can support you and know how overwhelming it can all be.

Thank you, you are all very helpful and knowledgeable , although still very confused I don't feel so isolated now.

 

[Type1Bri]

Hi, I have recently been confirmed type 1 after initially being diagnosed type 2, I have been forced off work by company doctor as my bg levels are too erratic for the last 4 months. Safety first on the railway. I'm seeing the hospital for my first appointment next week and I'm thinking I would like to move away from injections and on to a pump as I work both day and night shifts and would be able to keep in range easier and safer around the trains as I work at track level with the trains. Does anyone have experience of the pump or any advice please.

Hi @Vaper I have been pumping 4 months now and I love it
https://type1bri.com/difference-pump-makes