Easter

[noblehead]

I have not been at all keen to switch from mixed to the basal/bolus regime as the idea of carb counting and injecting 5 times a day is a bit off putting. However, I'm now realising I do have restrictions in order to keep my bg levels within my target (no less than 5 and no more than 9). My hospital is not a DAFNE centre, so I have no access to the course, but could my DSN swap me over without me doing the course? Lastly, could I be given a pump to avoid the multiple injections per day or would I have to wait ages for one?

Yes they can swap you over without doing the course June, the pump would be another option and you would have to discuss this with your diabetes consultant.

Some hospitals have their own in-house version of the DAFNE course, but don't forget there's some good on-line carb counting courses like BDEC which are extremely good by all accounts:

http://www.bdec-e-learning.com/

 

[June_C]

Yes they can swap you over without doing the course June, the pump would be another option and you would have to discuss this with your diabetes consultant.

Some hospitals have their own in-house version of the DAFNE course, but don't forget there's some good on-line carb counting courses like BDEC which are extremely good by all accounts:

http://www.bdec-e-learning.com/

Thanks Noblehead for the info. Something for me to think about.

 

[phoenix]

Carb counting isn't difficult to learn and is probably important for everyone on insulin. If you are using a mixed insulin, it will work better with a consistent carb intake and you can't work that out without carb counting to a degree.The BDEC course goes further and teaches you to make adjustments to basal and bolus insulins
re pump
I know some of the consultants are quite liberal in the way they interpret NICE pump guidelines (and some ultra strict by all accounts) so from what I see on this forum , pump availability seems to be dependent upon where you are. However, the guidelines actually mention having been using MDI as a condition. https://www.nice.org.uk/guidance/ta151
Also as a pump user, I would point out that there is actually a bit more 'maintenance' required with a pump (frequent testing, changing of reservoir, cannula etc) Also, after almost 7 years pumping, I still find the actual insertion of the cannula far more daunting than injecting.
.

 

[June_C]

Carb counting isn't difficult to learn and is probably important for everyone on insulin. If you are using a mixed insulin, it will work better with a consistent carb intake and you can't work that out without carb counting to a degree.The BDEC course goes further and teaches you to make adjustments to basal and bolus insulins
re pump
I know some of the consultants are quite liberal in the way they interpret NICE pump guidelines (and some ultra strict by all accounts) so from what I see on this forum , pump availability seems to be dependent upon where you are. However, the guidelines actually mention having been using MDI as a condition. https://www.nice.org.uk/guidance/ta151
Also as a pump user, I would point out that there is actually a bit more 'maintenance' required with a pump (frequent testing, changing of reservoir, cannula etc) Also, after almost 7 years pumping, I still find the actual insertion of the cannula far more daunting than injecting.
.

Oh dear, this is putting me off a pump, but I don't want to inject 5 times a day. I think the expression is "between a rock and a hard place"

I have actually started carb counting as I wanted to see what different foods did to my bg levels. In my dreams, I saw myself with a pump, just dial up the units, press a button, all done and also have a CGM so no more finger pricking. Didn't consider the cons, just the pros. I think it's time I took off the rose tinted spectacles

 

[June_C]

Carb counting isn't difficult to learn and is probably important for everyone on insulin. If you are using a mixed insulin, it will work better with a consistent carb intake and you can't work that out without carb counting to a degree.The BDEC course goes further and teaches you to make adjustments to basal and bolus insulins
re pump
I know some of the consultants are quite liberal in the way they interpret NICE pump guidelines (and some ultra strict by all accounts) so from what I see on this forum , pump availability seems to be dependent upon where you are. However, the guidelines actually mention having been using MDI as a condition. https://www.nice.org.uk/guidance/ta151
Also as a pump user, I would point out that there is actually a bit more 'maintenance' required with a pump (frequent testing, changing of reservoir, cannula etc) Also, after almost 7 years pumping, I still find the actual insertion of the cannula far more daunting than injecting.
.

Have just read through the NICE blurb and I don't think I'd be offered a pump as I have my bgs well controlled and have only had one mild hypo (so far). I just don't fit the criteria unfortunately. I can also understand the reluctance to offer a pump as I had no idea they were so expensive. I appreciate the NHS is not there to make my life easier, (avoiding MDI), but just keep me alive.

 

[Jaylee]

Have just read through the NICE blurb and I don't think I'd be offered a pump as I have my bgs well controlled and have only had one mild hypo (so far). I just don't fit the criteria unfortunately. I can also understand the reluctance to offer a pump as I had no idea they were so expensive. I appreciate the NHS is not there to make my life easier, (avoiding MDI), but just keep me alive.

Hereby lies the irony with me too..

I was given in my youth the "if your a good boy with the diabetes." Blah blah. "they're developing this bionic pancreas pump." Blah de blah. "Maybe even a transplant.!!?" Blah blah blah.. "So keep yourself healthy.... And...." Yes, and....

More bemused by it than anything else..
The injections never bothered me.. Still hypo aware. & I pass up on the sweets offered round..

The future is now. & I guess not everybody gets to ride the "hover board."

 

[June_C]

Hereby lies the irony with me too..

I was given in my youth the "if your a good boy with the diabetes." Blah blah. "they're developing this bionic pancreas pump." Blah de blah. "Maybe even a transplant.!!?" Blah blah blah.. "So keep yourself healthy.... And...." Yes, and....

More bemused by it than anything else..
The injections never bothered me.. Still hypo aware. & I pass up on the sweets offered round..

The future is now. & I guess not everybody gets to ride the "hover board."

Life's not fair is it?

 

[Jaylee]

Life's not fair is it?

It's been fairer for me than most I know..

 

[phoenix]

Just to emphasise it does depend on where you live , some consultants are far more proactive and enthusiastic about pumps than others . So for those that do want them, they may find that there is some flexibility in the interpretation of the guidelines. I know people who have changed clinics and then been able to obtain a pump.
( I live in France so no NICE guidelines but the doctors make similar judgements I got one because I did a lot of exercise and found it hard to stop low levels when exercising. I wasn't scared of them because I could treat them quickly. One could say that they did impact on my lifestyle. I certainly know of people in the UK who have been able to obtain pumps under similar circumstances.)

 

[noblehead]

Have just read through the NICE blurb and I don't think I'd be offered a pump as I have my bgs well controlled and have only had one mild hypo (so far). I just don't fit the criteria unfortunately. I can also understand the reluctance to offer a pump as I had no idea they were so expensive. I appreciate the NHS is not there to make my life easier, (avoiding MDI), but just keep me alive.

June, there's many on the forum who have good diabetes control and still been put forward for a pump, there was a guy on the forum around two years ago (who had an Hba1c in 4's) and he still moved over to pump therapy because his present insulin therapy was effecting his quality of life (and his consultant agreed that a pump would improve it), so don't dismiss the possibility that a pump might not be offered to you now or in the near future as quality of life is a big consideration when consultants are accessing a patients suitability for a pump.

 

[autoimmune chrissy]

You can still have chocolate,when I was first diagnosed I didn't eat anything sweet for 3 years,but I have the occasional chocky bar just look on the bar and ajust your insulin

 

[gemma6549]

Will do.

When I'm feeling a bit better I will mix the rest of the Lindt with some hot cream and make my own truffles.

Don't like to throw things away well not food anyway!!

So hotel chocolat said the 65% supermilk has 23g of carbs per 100g.

Not bad for a milk version.

Might give that one a go

 

[poohtiggy]

I couldn't live without the occasional bit of chocolate and buy Moser Roth from Aldi, it's 85 per cent cocoa and 4.6 grams per bar and you get 5 bars in a pack, and it's yum

 

[Jaylee]

Just to emphasise it does depend on where you live , some consultants are far more proactive and enthusiastic about pumps than others . So for those that do want them, they may find that there is some flexibility in the interpretation of the guidelines. I know people who have changed clinics and then been able to obtain a pump.
( I live in France so no NICE guidelines but the doctors make similar judgements I got one because I did a lot of exercise and found it hard to stop low levels when exercising. I wasn't scared of them because I could treat them quickly. One could say that they did impact on my lifestyle. I certainly know of people in the UK who have been able to obtain pumps under similar circumstances.)

Hi, thanks for you encouraging comment on the pump Phoenix.
I feel in my case regarding my healthcare geographical location the "funding" is great.. The test cartriges for my Mobile? As many as I want..!
Indeed I have a fantastic raport with my surgery across the board..
The issue might well be the technology involved in the pump managment regime for my Doctor & nurses..? This is not to undermine my surgery's professanalism. They certainly don't try to undermine my D managment..

What it boils down to in my case is the consultants I see are a health care team & not an Apple store..
I may need to change tact bearing this in mind...

 

[June_C]

June, there's many on the forum who have good diabetes control and still been put forward for a pump, there was a guy on the forum around two years ago (who had an Hba1c in 4's) and he still moved over to pump therapy because his present insulin therapy was effecting his quality of life (and his consultant agreed that a pump would improve it), so don't dismiss the possibility that a pump might not be offered to you now or in the near future as quality of life is a big consideration when consultants are accessing a patients suitability for a pump.

I've come up with, I think, a good reason for having a pump. I babysit my grandson aged 3 years, 3 times a week. Sometimes this clashes with an insulin injection and I have to retreat to the bathroom to inject as I don't want him to see me sticking a needle in my tum. This is not an ideal situation when responsible for a toddler who can get up to mischief in a second. They need to be watched at all times. If I went over to MDI, this situation would only get worse. Maybe this might be a good reason for having a pump. It's a thought, but perhaps I'm being too optimistic.

 

[donnellysdogs]

Notmally they would want you to have tried all methods of insulin and still no improvement in control. I do no somebody that went straight from mixed insulin to a pump though but had a battle initially as the consultant didn't want him to have one but the DSN thiught it would help. He had never counted carbs in over 35 years as a T1, so had to do a carb counting course first.
Mums also have to inject in fromt of their children etc so may not be a valid reason.

 

[June_C]

Notmally they would want you to have tried all methods of insulin and still no improvement in control. I do no somebody that went straight from mixed insulin to a pump though but had a battle initially as the consultant didn't want him to have one but the DSN thiught it would help. He had never counted carbs in over 35 years as a T1, so had to do a carb counting course first.
Mums also have to inject in fromt of their children etc so may not be a valid reason.

Thanks for that. I shall now go to bed depressed I think I may stick to the mixed insulin and live with the restrictions.

 

[poohtiggy]

My diabetese has never been mentioned in front of my little grandaughters age 2 & 4 because we didn't think it necessary to 'worry little minds' however, I have been looking after them a lot recently and still needed to test. One day I was sneakily testing in the kitchen when the 4 year old came in and asked what Nana was doing. I just explained that my tummy didn't work properly and I had to check if it was safe to eat my lunch. Now she asks 'did Mr Blood say we can have lunch Nana'?Kids....they adapt to anything and they are not phased at all, they accept so easily and I'm pleased I no longer have to hide

 

[tim2000s]

I tend to agree. The only thing that a toddler is likely to take from this is that grannies sticks a needle in herself and it doesn't hurt, which is a great thing!

 

[Jaylee]

Thanks for that. I shall now go to bed depressed I think I may stick to the mixed insulin and live with the restrictions.

No need to feel depressed.. I kind of feel Yer pain. Felt it for years.. Remember what Easter is realy about.. The "sacrifice".. One guy getting nailed to a tree for everybody else's sins. Then bouncing back a few days later...