Pump

[moori]

Hi!

I am diabetic for about 8 month now.
Wondering how long you need to wait for a pump.
Injecting is driving me insane. Having to always have the pen with me...
And people dont really know about me, trying to keep it quiet...

 

[Juicyj]

Hello @moori

Firstly your team would want to make sure you're no longer 'honeymooning' as this is an unpredictable stage and it's best managed with multiple daily injections, next you need to be carb counting and to of done a Dose Adjustment for Normal Eating (DAFNE) course. Then there needs to be a good case for funding for a pump, if you check NICE guidelines to understand criteria, the NHS don't hand out pumps due to cost, so having a excellent understanding of type 1 management is a good basis as well as keeping up to date with your appointments and building a good relationship with your DSN. It took me around 4 years to finally get approval for pump funding, I was turned down a few times before this so having a pretty thick skin helped and not getting too despondent when rejected, my attitude was if I get it then great, if I don't I can still manage on MDI, however i'd changed basal 3 times and was still struggling with maintaining decent control, also the pump is not a magic wand, your knowledge in managing it is critical to having excellent control so being able to review ratios regularly, make adjustments and understand patterns make pump management work hence why going on educational courses and proving to your team that your knowledge is good is important. Are you ok with wearing a pump 24/7 ? Something else to consider.

Carrying a pen with you is hardly an issue is it ? are you carrying a hypo treatment with you at all times too ?

If I was you I wouldn't keep it quiet, I was the same after diagnosis, a turning point for me was actually injecting in a restaurant under the table with people all around me, but I was discreet and no one noticed, however it gave me confidence and was a bit turning point then. In some respects it helped me accept my type 1 when I became more open about it, what if you have a hypo, how do you explain a low to someone who doesn't know your condition ? I don't tell everyone, it's a need to know basis but if i'm spending time with people then I tell them, better they know and saves potential embarrassment too if you do have a hypo.

 

[Rokaab]

I don't tell everyone, it's a need to know basis but if i'm spending time with people then I tell them, better they know and saves potential embarrassment too if you do have a hypo.

Definitely, as an example - a number of years ago I started a new job and telling work people about my diabetes was on my list of things to sort out, however before I got round to it (in the first week or so) I had a monster hypo at work, they had to ring my mum to find out the details - imagine how embarrassing it is for your work to have to call your mum when you're not too far off 30! (it also obviously worried my mum no end - I think she then rang me every day for a week (didn't live close by) to check up on me)

 

[Colin of Kent]

Depending on your own situation, you may find MDI more manageable than a pump. The pump is certainly no easier, in my view. The only really useful thing it offers is the ability to tweak your basal rate very finely, which for me is important.

You say you don't like having to carry the pens around with you, but if you have a pump, it's wise to carry spares around all the time anyway, as they can and do fail without warning. Thankfully, it's rare, but if it does happen, things can go downhill pretty rapidly unless you're prepared. I always carry spare infusion sets, batteries and insulin, plus I have pens on hand if travelling.

 

[Deleted Account]

I got a pump 12 years after my diagnosis.
Whilst it gives me better control than injecting, it is not easier.
I have to be more accurate with carb counting.
The impact of something going wrong is more with a pump (if my pump fails or gets disconnected, I can quickly get very high BG).
I have much much more paraphernalia to carry around with pump supplies and spare insulin pens.
There are more things to control so more to go wrong with pump settings and set changes

If you really want a pump, you need to consider why you need one and how you can convince your diabetes team. Inconvenience of carrying pens is not the reason the NHS would spend thousands of pounds.