Jeannie, I can't say I ever had such good control with MDI so I can't say much about how that may affect your motivation. For me that is a big reason. But the second reason you can consider it is the flexibility. For me, once I have my base rate settled, it means that the slightest effort - twenty-minute walk to the shops, vacuuming the house, let alone actual real-life exercise - has me hypoing like crazy. Or I have keep stuffing carbs down myself. If I am trying to get fitter or lose weight, it's really frustrating.This is copied from my reply on the introduction forum.......Well I am back, took me a while to find my original post on here, was surprised it was January!! Update on my progress or lack of it with pump to follow. Apparently the only pump nurse at my clinic is away on long term sick leave, which means my lovely dietician who works part time, is rather overloaded with pump start up meetings. Took my husband along with me in early March to a meeting with her, and to take a look at two different pumps which are available. The one I liked was a very new one - can't recall now the exact name, but it was Accucheck and it was a Bluetooth affair with remote control dosage on the blood test meter. So, it was agreed as soon as my dietician could manage a start up meeting, with other new to the pump diabetics. I would give it a go. Well that was almost a month ago, and it's given me way too much thinking time. Also to confuse matters, my control just lately with NovoRapid before meals and Levemir (twice daily has actually improved so much near to perfect results, if sometimes even a wee bit too low. So now I am confused, I am still not sure if I want to be attached to a pump, I am liking the flexibility I have with the pens, and seem to have totally reversed how I feel about getting a pump. Would be very grateful for anyone's advice or experience of similar. I live In Scotland, where availability of insulin pumps is very good and also use of pumps encouraged. I am starting to wonder whether after 43 years of being a relatively well controlled diabetic, am I too old to get to grips with a pump. Any advice most welcone
This is copied from my reply on the introduction forum.......Well I am back, took me a while to find my original post on here, was surprised it was January!! Update on my progress or lack of it with pump to follow. Apparently the only pump nurse at my clinic is away on long term sick leave, which means my lovely dietician who works part time, is rather overloaded with pump start up meetings. Took my husband along with me in early March to a meeting with her, and to take a look at two different pumps which are available. The one I liked was a very new one - can't recall now the exact name, but it was Accucheck and it was a Bluetooth affair with remote control dosage on the blood test meter. So, it was agreed as soon as my dietician could manage a start up meeting, with other new to the pump diabetics. I would give it a go. Well that was almost a month ago, and it's given me way too much thinking time. Also to confuse matters, my control just lately with NovoRapid before meals and Levemir (twice daily has actually improved so much near to perfect results, if sometimes even a wee bit too low. So now I am confused, I am still not sure if I want to be attached to a pump, I am liking the flexibility I have with the pens, and seem to have totally reversed how I feel about getting a pump. Would be very grateful for anyone's advice or experience of similar. I live In Scotland, where availability of insulin pumps is very good and also use of pumps encouraged. I am starting to wonder whether after 43 years of being a relatively well controlled diabetic, am I too old to get to grips with a pump. Any advice most welcone
Jeannie, I can't say I ever had such good control with MDI so I can't say much about how that may affect your motivation. For me that is a big reason. But the second reason you can consider it is the flexibility. For me, once I have my base rate settled, it means that the slightest effort - twenty-minute walk to the shops, vacuuming the house, let alone actual real-life exercise - has me hypoing like crazy. Or I have keep stuffing carbs down myself. If I am trying to get fitter or lose weight, it's really frustrating.
But with a pump, I turn my basal rate down for a couple of hours while I do housework, or longer if I am exercising and it reduced the need for stuffing my face with carbs any time I do anything spontaneous! So that's my second big reason for loving it.
Thanks RuthW! Well my control until the autumn on MDI has been good, see my reply below to Ann. Also I inject my NovoRapid after I've eaten, so it's fairly flexible for me. And now my control has gone back to normal, just as the offer of a pump is waved in front of me! I will keep you posted and thank you very much for your input, it's invaluable
Reading your posts, Jeannie, i am even more surprised you are thinking of a pump, if control is good without hypos (i dont know your age, but in my hospital your numbers would be seen as too low for a woman over 60 - i had numbers like you for years and hav now been warned about going under 7.0%.after recent research findings ). Maybe you could ask for a trial as it is easier to get them in Scotland? I agree with RuthW re the exercise point and base rate alterations, and gillkin re the ability to alter the base rate over the whole day - i do this all the time, and have learnt the reasons why injections never worked for me. Using under 20 units per day during virus free months - a distant memory after the last 2 months of illness! - and as little as 0.150 - 0-2 units per hr at certain times of the night, (and up to 0.4 units per hr at others), it is clear that injections just could not cope with my needs, and explains why night hypos were always a problem. They can still happen, and i am still in fear of them, but they are rare on the pump. Exercise is not as easy as it is for Ruth. I really have to suspend the pump entirely or have 0.1 units p hr, even for a short brisk walk, and have to plan the base rate change 2 hours in advance. The post exercise effect is not so easy to plan for as it is changeable. Re weight loss, ask your dietician for more details!! Weight gain on the pump is common! I gained weight, only a few pounds, but i had to cut CHO even more - there is less wastage of calories on the pump, or was for me. Be interested to know your decision!Since the past 3 years, I meant to add my HBA1c has been at totally normal levels, although slightly raised a few months ago from the previous result but nothing to worry about, also my eyes have passed all the relevant tests too.
Hi, Tim, the whole area is very controversial at present, esp re the published studies, see below most are related to type 2, there are a lot i may not have included, and the one or two which have looked at type one do not find the same problem, but very recently there have been studies on type one women showing they have a relatively higher risk of CVD than Type one men. (ie, they still have a lower risk in numbers but relative to the general pop they have a higher risk). It seems clear that hypos are not good re CVD for Type 2, but until recently little was done on Type 1.Hi @ann34+ would you mind posting a link to the research you mentioned? Thanks.
This evidence all seems pretty weak doesn't it?
It's also the type of situation where a public policy decision is different from an individual patient decision.
Say hypothetically the mortality linked low HBa1c targets (targets, not HBa1c) is caused by hypos or by erratic BG or both. As a public body you might say "don't set low HBa1c targets". But as an individual you could well decide "I will aim for low HBa1c but make sure I do it without hypos or erratic BG, I'll make avoiding those a higher priority than the lower HBa1c".