NHS artificial pancreas roll out.

[Zinadane]

So I wont be offered one as my hba1c is not above 58mmol?
300,000 type 1s in the UK.
I wonder what number/percentage of people with type 1 will be catered for with the 58mmol threshold criteria?
I'm some way of 58, but I guess if your hovering between 50-55 then this is an incentive for you to worsen your control and qualify for an artificial pancreas!

 

[Jasmin2000]

So I wont be offered one as my hba1c is not above 58mmol?
300,000 type 1s in the UK.
I wonder what number/percentage of people with type 1 will be catered for with the 58mmol threshold criteria?
I'm some way of 58, but I guess if your hovering between 50-55 then this is an incentive for you to worsen your control and qualify for an artificial pancreas!

Me neither. But it's all based on population healthcare economics and the rollout will save billions over the next 20-30 years according to some bod in the NHS budgeting department. Personalised medicine? Not so much.

Funny thing about meds/devices that reestablish your control over your life/lifestyle and tease you to behave like you want. If we didn't have insulin we would have less of an obesity problem but more acute sickness and death - comes with the territory. Since I got statins, I've stocked up on the finest cheeses and duck eggs

 

[Fern Hopper]

I have recently been refused a pump anyway. Too well controlled and far too fit. Endocrinologist couldn't understand why I had been referred. But then I suppose I am nowhere near a priority. 66 years old.Type 1 for 57 years. HbA1c of 37. BMI of 21.5.

 

[Zinadane]

I have recently been refused a pump anyway. Too well controlled and far too fit. Endocrinologist couldn't understand why I had been referred. But then I suppose I am nowhere near a priority. 66 years old.Type 1 for 57 years. HbA1c of 37. BMI of 21.5.

Excellent work to get 37hba1c
No pump for you!
The other end of the spectrum, there will be someone who puts no effort into their diabetes management, will be given a closed loop pump and can then have the lifestyle of a non diabetic and will have a hba1c potentially down in the mid 30s.

 

[Fern Hopper]

My HbA1c has always been low. I much prefer it this way. I have been told recently to make it higher because I am incredibly old.

 

[Fern Hopper]

But I did run a 23 minute Parkrun at the weekend.

 

[jaywak]

I was always turned down for a Libre until recently because my control was always thought of as very good so I guess the same criteria for an artificial pancreas will be the same .

 

[becca59]

Look on the bright side. Like Libre it will filter through eventually.
You have a low HbA1c because you work at it and prioritise your health and well being over anything else.
Remember there are some people who do the above who still don’t achieve good results.
And no child will be diagnosed without going forwards with this technology.

 

[Herbie1972]

I have recently been refused a pump anyway. Too well controlled and far too fit. Endocrinologist couldn't understand why I had been referred. But then I suppose I am nowhere near a priority. 66 years old.Type 1 for 57 years. HbA1c of 37. BMI of 21.5.

How on earth do you have an HbA1C of 37?!! Absolutely wow!!!!!

 

[Herbie1972]

Basically, though, the media hype is just saying that the closed-loop pump that lots of people are already on will be rolled out to more people, rather than some groundbreaking new tech that's been launched. Is that right?

 

[Herbie1972]

My HbA1c has always been low. I much prefer it this way. I have been told recently to make it higher because I am incredibly old.

Do you have any diabetes complications?

 

[Jc3131]

My hba1c is 49 and I've been asked if I have a lot of hypos, which I dont, just mild ones that I always catch.

They are saying my control is too tight, but I don't think it is. I asked about a pump last year when my hba1c was 51 and they said that my control is too good.

So even though I'd like to give the closed loop a try, I have no chance yet of getting one.

 

[Fern Hopper]

No. Rarely hypo. Still get very good hypo warning signs. No retinopathy. No neuropathy. No problems with kidneys or liver. I did have a cancer diagnosis and treatment 18 months ago. Recovered very well. Was back running Parkrun within 3 weeks of surgery - although I probably shouldn't have done!

 

[Fern Hopper]

I was told I need to raise my HbA1c because at my advanced age I might go hypo in the night and fall down the stairs.

 

[Ushthetaff]

To be honest I’ve had diabetes that long now I don’t find it a pain any more , I’ve got plenty of complications but it doesn’t get me down I just move on and deal with whatever comes my way . My hb1c is ” healthy “so that’s fine for me, probably too stuck in my ways now . It’ll be good for future generations though , just hope “ we” don’t have to go through the old hoop jumping process again

 

[Fern Hopper]

Sometimes though I think being stuck in my ways makes control easier for me. I still like to eat at the same times. I don't miss meals. I eat very healthily.I rarely eat things like cake. I have always exercised a lot because it makes me feel better.

 

[Nicola M]

I do think that there does have to be a cut off point at which they offer it as realistically it isn't feasible to offer every single person this extremely expensive tech when they are able to manage their diabetes with treatment that costs much less.

I was one of the few who got onto the Trial that kickstarted them beginning to offer it to more people, the criteria to even get onto the trial meant that if I am remembering correctly your HbA1c had to be above 70 and whilst to many that is a shockingly high number to me that was the norm, even with using an insulin pump I was in severe burnout and without a hybrid-closed loop I don't know where I would be now. I am eternally grateful for what the system has done for me and what it can possibly do for others.

 

[Jasmin2000]

I was told I need to raise my HbA1c because at my advanced age I might go hypo in the night and fall down the stairs.

What if you live in a bungalow - can you then have a lower A1c? The logic of the NHS astounds me sometimes.

 

[EllieM]

I'm in New Zealand where one of the pump criteria is hypos. I've had "reasonable" control for at least the last ten years but they have just funded a pump for me because of hypos. (No hospital admissions for 6 years but I have lost hypo awareness for periods in the past and had some bad nights struggling with lows, and highs.)

Looks like 90 of my hospital's 400 T1s are on pumps?

But you still have to bolus for meals and be aware of your levels. Injected insulin takes time to act and peaks at 1 to 2 hours and goes on acting for 4 or 5 (I'm on humalog), so I don't think that a pump is really an artificial pancreas, even if it does make life easier. And it has drawbacks as well as advantages. (I'm still in the very early day of a tandem tslim and about to move to control iq, which is meant to be closed loop).

But I think that some people's T1 is genuinely easier to manage than others, we all react differently to exogenous insulin, so it's not a question that people who aren't making the effort are being rewarded, it's a question of finding the best way to manage everyone's T1, in their different circumstances.

 

[Fern Hopper]

It looks like the NHS (bless 'em) are prioritising the right people. I appreciate that I am certainly not a priority. It might be that I would find it all a bit of a distraction. But I might live a lot longer and just get one because I'll be the only person without. I can wait!