How does pumping work?

Charisma_1630

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I'm currently going through a very very long process of trying to get a pump from my hospital. Anyway I was sent to the dietician yesterday and asked her some questions about pumping. She said that the slow trickle of fast acting works in exactly the same way as a long acting would, and that the insulin before meals is administered in the same way as a pen is (as in all in one go) She did seem to be trying to put me off as she admitted she doesn't like them but I have been wondering since then as I've heard the majority of people say it's improved control, how does it improve control when it works the same way as daily injections?? Sorry if it's a really obvious question!
 

Mrsass

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They got the dietician to explain about a pump!? Why doesn't she like them? Was there a reason?

Anyway, I've had a pump for around 18 months, love it. Control has improved, hba1c has gone from 66 to 44, it does take a fair bit of work, it's not magic, I think some people think that if they get a pump it will just make everything ok, but it's a lot of bg testing to work out what's best for you.

Your bolus before a meal does not have to be given all at once you can chose for it to be given over a set amount of time.

To me my pump is more like having a working pancreas, I was on injections for nearly 25 years and was never able to get my control quite right.

Abbie :)
 
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noblehead

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Abbie's reply is excellent.

The following is an excellent website that explains what a insulin pump is and the process involved in getting one on the NHS:

http://www.inputdiabetes.org.uk/alt-insulin-pumps/what-is/

A pump is far removed from MDI as you have the ability to fine-tune your insulin doses to your bodies needs, with most pumps you can have multiple basal rates running to give a better 24 hour coverage, also you can set temporary basal rates to deal with things like illness and exercise.

As Abbie says with a pump you can deal with difficult meals by delivering the bolus dose over many hours, this is particularly handy for meals that are high in fat or are low-carb.
 
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carol anne

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It's not the same as injecting the pump gives yu different combos 50 50 I s one I use for meals yu get 50% in one and 50% over 2 hours there are a lot of different combos to use its brill don't be put off grab it with both hands it will change your life x
 
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Charisma_1630

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Your bolus before a meal does not have to be given all at once you can chose for it to be given over a set amount of time.

Abbie :)

This!! I questioned this with her as I thought that's how it worked and that's more like How a pancreas worked and she said I was wrong!! She also told me my morning ratio was too high "as its he highest she's ever seen" and it must be that my lantus is wrong "as it looks like far too low a dosage" even though I know it's not! I've done tests!!

I saw the consultant just before I saw her and he said ive clearly worked really hard to control my sugars and I have had bad anxiety for 2 years now and get random lows! He said he will try and help me and a pump may be one option. I have to work with the dietician first for 3 months then see what the next step is but I'm not gonna get anywhere with her as she's so anti pump! She said she thinks it's unnecessary and it works the same way as injections. Ive very rarely heard people say a pump hasn't helped them that's why I was confused if they did the same thing why would people prefer a pump! I've done carb counting I test regularly I keep detailed diarys!
 

noblehead

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@Charisma_1630, the decision to move over to a pump isn't for the dietitian to decide, her knowledge of them is sadly lacking.
 
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Mrsass

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This 'dietician' sounds really lovely and helpful!

At what point did she do pump training and gain all of her knowledge that she is passing on to you?

Has she seen results that show a pump doesn't work and proves its 'unnecessary'

These are the questions I'd be asking her before I walked out and asked to see someone else!

Best of luck coz I think you are going to need it with her :(
 
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Charisma_1630

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I know I thought it was odd after everything I had read online. Luckily I've done a lot of research over the past 2 years on things like diet, I already knew a lot of things she were telling me and didn't agree with all of it! Unfortunately I have to deal with her for the next 3 months until I can see the consultant again. :-(
 
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Charisma_1630

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Hello, I thought I'll put this on here instead of starting a new one.

I usually have a steady overnight blood sugar. The dietician I described above advised before I see her again in a few weeks I try and do some long acting testing by eating no carbs. She says my long acting looks too low and my morning ratio is the highest she's seen (3 units for 10g carb surely not that high) anyway I woke up on 6.3 this morning, I had 2 eggs scrambled with butter and 2 bacon. 1 hour later it was 10.0 I had 1 unit to try and correct me (1 brings down 4) and before lunch I was 13. Usually I have porridge and back to normal by lunch. Shall I try skipping breaky tomorrow and seeing if it's just that my blood sugar starts to raise on its own once I wake up (which is what I suspect) something which might help my case in getting a pump.
 

noblehead

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Yes do that tomorrow @Charisma_1630.

Did you bolus for the eggs & bacon this morning? I find that I need nearly as much insulin for a no-carb breakfast than I do for a carby breakfast.
 
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Charisma_1630

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I didn't. She told me with no carbs I shouldn't budge at all if my long acting is correct. I also questioned about protein as i thought she was wrong I asked "so if I ate ten eggs or ten chickens it won't affect me at all" and she said that's correct which I'm pretty sure is wrong!
 

noblehead

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I'm the same. Perhaps, I don't need quite as much but I still definitely need insulin.

It's quite strange isn't it, the difference between the two for me is just one unit.
 

Charisma_1630

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But my dietician is going to try to up my long acting because of this as she doesn't believe it makes u go up. If I do that I'll start hypoing in the night. She's very difficult to work with as she's so by the book
 

noblehead

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But my dietician is going to try to up my long acting because of this as she doesn't believe it makes u go up. If I do that I'll start hypoing in the night. She's very difficult to work with as she's so by the book


Understand that some Dietitians are DAFNE trained but I'm confused why you are being seen by a Dietitian and not your DSN, the DSN is the best (and more experienced person) to give advise on insulin and insulin doses.
 
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Mrsass

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@Charisma_1630 I really worry about this dietician they've got you seeing!! As @noblehead said above the DSN is the best person for you to be seeing.

saying you wouldn't need to bolus even if you had 10 eggs etc is just ridiculous, yeah maybe some people are ok with a few eggs (not 10) most of us do get a rise because of the protein. I hope the 3 months of you having to see her (that you mentioned in earlier post) is nearly up now! X
 
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Charisma_1630

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Thanks it's nice to know I'm not just being funny about it. I've made an appointment to see my diabetic nurse next Tuesday so I'll tell her about my concerns! I have a month until I see the dietician again, not looking forward to that appointment!
 
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Heathero

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Find mention of Hypos on pump concerning, due to start with Omnipod soon, find trial good. Was informed hypos less likely ? How many weeks does it take to stabilise? Have been advised to take time off work as need to do blood test 1-2 hourly day and night for two weeks. Do I need to worry? Work driving daily.
 

donnellysdogs

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Hypo's will depend upon you getting your basals n bolus's etc correct.
Pumps don't eliminate them per se... The users knowledge and understanding and commitment does that...
 
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