told that a pump would be advantages to me

phil169

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hi all iam type 2 diabetic with a very high bs (26-37). I have been told by the diabetic team at the hospital that they think a pump would suit me better than mdi as they are not working iam now on lantis and apidra 2 lantis injections of 90 units 1 morning and evening with a 1 to 1 carb ratio. I see the doc at the hospital next week to discuss this with him.? 1) do you think this will work and bring down bs reeding?
2) if so what pump do you think I should use.?

thanks for the help.
 

EchoIsGreat

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Sounds like you're type 1 now. Medtronic MiniMed Veo is an excellent compact little pump as long as your eyesight is good. The liquid quartz display is a bit small.
 

Spiker

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Phil that very high dose and high carb ratio suggests a very high insulin resistance and probably a high body mass?

If you try a low carb diet to reduce your weight you will improve your insulin resistance and lower your insulin requirement a lot. I'm not sure that just finding a more efficient way to pump loads of insulin into your highly insulin-resistant body is really a good answer. To be very honest with you.
 
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phil169

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hi spiker
thanks for the help but I have now lost 5.5kl and now only 79.5kl and thay say I must eat moor to try and stop the weight loss. my bm is 24.4 .and I am 5ft 9 I have been on a low carb count of under 50 carbs per day for the past 7 months now. it seems that even the smallest amount of carbs sends my bm up and it will just not come down. I think now the hospital are going to try anything they can to bring bm down.
 

Spiker

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Hey Phil that is a tough situation you face. Have you tried adding a lot of fat to your diet while maintaining the 50g or carbs a day? To sustain your weight.

Are they sure you are not a T1 diabetic? Have they tested for GAD antibodies and C peptide? Though your very high insulin levels do sound more T2 than T1, particularly on 50gCH a day.
Have you looked at the Newcastle Diet?
 
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donnellysdogs

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I know of other persons with larger amounts of insulin that pump through.

A pump does use less insulin than mdi.

You would need to consider Accucheks new one...as for people pumping over a unit per hour it will let them fine tune basal rates by 0.02. This is great compared to other pumps which have greater increments than 0.02. Ie if you pumped 1.05 an hour for two hours it would let you change to 1.03 and 1.07. Other pumps do, including roced current combopump only allow 0.05 increments once you pump more than 1 unit anhour.

You would need to look at one that has the biggest cartridge, orherwise you will end up changing everyday. Roche current combo pump is 315 but new one has less capacity.. Can't remember how much though.

I think that would be the two questions I would want to consider if its me. I would look up details of Roche new pump rather than the combo pump.
 
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phil169

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thanks for the help will look at the Roche pump see doc on Tuesday. hospital now think that I am near total insulin resistant. but think pump is the answer.

thanks all
 
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donnellysdogs

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thanks for the help will look at the Roche pump see doc on Tuesday. hospital now think that I am near total insulin resistant. but think pump is the answer.

thanks all

Hope you get on ok Tuesday. Don't forget, if you discuss a Roche pump - ask if you can wait for the launch of the new one. If you get given the combo pump you would be likely to have to wait 4 years for the upgraded one..
 
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phil169

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no to a pump from dr at hospital as he has not got a strong case for one instead put insulin up and add this another pill instead lost another 2kilo this week so told them NO I am stopping all treatment as of now and what will be will be.
 

Minnie45

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I feel for you Phil, I'm a type 1 on a pump and a good friend of mine is a type 2, over many years she's gone from diet to pills to insulin injections (she's now very slim but is very insulin resistant)and would desperately love a pump but has been told NICE guidelines exclude type 2s from NHS funded pumps. Would you be able to self fund?
 

donnellysdogs

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no to a pump from dr at hospital as he has not got a strong case for one instead put insulin up and add this another pill instead lost another 2kilo this week so told them NO I am stopping all treatment as of now and what will be will be.

Do you alter your own insulin Phil? Or is it always under the guidance of consultants etc.

What are daily readings ranging from and too?

Trouble is consultants etc do need to see that Patient and they have tried every angle of alternatives to even consider..

What pill have they tried to add for you to take?
 

CarbsRok

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no to a pump from dr at hospital as he has not got a strong case for one instead put insulin up and add this another pill instead lost another 2kilo this week so told them NO I am stopping all treatment as of now and what will be will be.
Hi Phil it's just a suggestion for you, but have you tried different types of insulin such as animal insulin? It could be that it's the insulin type that's the problem and not you, if you see what I mean.
It's very rare for a type 2 to be given an insulin pump though so wasn't surprised at the no.
There is also a U500 insulin which can be prescribed on a named person basis, which would also cut down the amount you need to inject.
 
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donnellysdogs

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I know you say your readings were 26-37, my concern is multi level on this...are they still remaining at this level?

As mentioned above there are other insulins especially the U500. Did your consultant mention any swapping/trying a different type?

Another loss of 2kg is not really wanted is it? You need more calories. Have you tried eating food that was mentioned above by other OP's.

When are you seeing consultant again? What was your last hba1c test
result?
 
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phil169

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have tried metformin, and all the common ones now been give one that has a side effect of cancer ( metformin and the other made me vomit and the other way to every day for 5 months). so now I am ready for a fight. I have tried there way swallowed every pill they have given me stuck 8-17 needles a day in me pushed 300- 350 units of insulin in me well I have called time on it all had GP on phone say I will die if I don't take the insulin and all that well it isn't working and so I am doing it no moor what will be will be die that could be a good thing at this point sick of fighting this and it having control over me well no moor it time to get on with life and sod the needles and tabs if I am going to die then at least I will have don it my way. thanks for the help every one and good luck with it all
 

donnellysdogs

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Phil

So **** heartbroken to be honest that you feel so let down and so at the end of your tether with it all.

Can I please ask just two questions
1) Are you under GP care or with a Consultant?

There is a U500 insulin that some nhs people just aren't aware of...

I can read that you are very angry at not being able to get stabilised with bloods and meds. Please from me, a personal request, don't give up, please.....

2) have you had the test to rule for definite that you are a type 1 not type 2?
 
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phil169

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hi donnellysdogs

Please don't be heartbroken but look at it has I now have my life back with out any needles, insulin or blood tests and no moor being tied to I can not do that or eat that my new life has just begun. in answer to you questions

1) under consultant.

2) no need for that test as I am type 2 they say just very insulin resistant ( today he said extremely insulin resistant ). he wanted to put my basil up by 20 units and my bolas up to 1 unit to every 0.5 grams of carbs + another tablet to try I said no I leave that and he showed me the door.

but don't worry about me as I am fine at the mo thanks mate
 

donnellysdogs

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Ok, so were you just declared type 2 because of age or excess weight initially or something similar? To be honest I would ask you GP to do the type 1 test to make sure that you have not been misdiagnosed. If you were type1 then it would be easier to get a pump (nigh on impoosible for a type 2 I believe).

Had you blood levels reduced? Or still high 20-30's? You are aware that stopping your meds is going to end up with you being very ill and DKA?

Is it possible to ask your GP for a referral to a different hospital?

Seriously, please will you consider restarting meds and going back to see you GP and ask to see an endochrolgist with knowledge of u500 insulin...

I do very much worry for you, as stopping insulin is like being a non swimmer and taking your life jacket off in the Atlantic Ocean.
 
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Spiker

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Hi Phil

That is very frustrating that the hospital team suggested a pump and then the hospital doctor did not provide you with one.
 

Spiker

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Hi Phil

That is very frustrating that the hospital team suggested a pump and then the hospital doctor did not provide you with one.

However, it is not at all surprising, given the conversation you reported having with the doctor.

Even for those of us lucky enough to meet the NHS criteria for a pump, we have to jump through the hoops to get them. As you are trying to get a pump as a special case, it's even more important to jump through the hoops.

Jumping through the hoops means showing the doc you are able to take charge of managing your diabetes responsibly. It means working with the team. It means demonstrating you have tried all the alternatives, tried them properly.

If we don't jump through these hoops, we don't get pumps. It's that simple. Because a pump costs a lot of money and takes a lot of work and effort from us, the pump users. It's not an autopilot, you have to put effort in. If the doctor is not convinced you will put the effort in, he or she will not sign off on the high cost of a pump.

If you want the pump, that's how you, we, everyone, gets one. The only way. Not by refusing to work with them and walking out, I'm afraid. That's the reality.
 
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Spiker

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So the doctor made a pretty reasonable suggestion, which was to up your Lantus by about 20% and double your carb ratio for the Apidra. That means no extra injections for you, just bigger quantities.

You've also had many good suggestions from people here: maybe switch insulins, maybe use the U500 insulins. You can put these options in front of your doctor. That will show a constructive and informed attitude that could get the doctor back on side.

You know, Phil, that if you stop taking your insulin you will be hospitalised with DKA in a few days at most. It is extremely unpleasant. At worst, you could die. Not in a few years or a few months but a few days. Now the NHS is not, ever, going to give you a pump because you have harmed yourself or threatened to harm yourself, which is what stopping your insulin is: self-harming.

But, if you work with your team, they will find something that works for you. Maybe a pump, maybe not. That doesn't matter. What matters is that you work with them to find the answer. They can't do it without you, and you can't do it without them.

Think it over, and then give them a call back. It will be ok. It really will.
 
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