How to get a pump?

shell666

Member
Messages
8
:( I have had type 1 diabetes since 1985 and my control is not 100% I was offered a pump 6 years ago when I was pregnant with my 2nd child as I had 130 hypo's 3 really serious during my pregnancy. I decided not to have one as I did not want any further issues during the already stressful time as I was told I could have problems for the first few months! The hospital I was under at the time assured me that if I wanted to have the pump fitted after the baby arrived that I could have one. Now my daughter has just started year 1 at school and I am still waiting for my pump I have moved area and was told at my new hospital there is a criteria you must meet to have a pump, 1st you have to of completed the DAFNE course which I have done, now I am told my HBA1C level is not in the required area as for the last 2 years my count has been 7.4% I had it done last week and my level has now risen to 7.7%. but it should be over 8.5% to meet the criteria. My sugar levels in the mornings are always over 10 as I suffer from the dawn phenomanom , the last time I woke with a blood sugar in range I had to go to sleep on a sugar of 20, my sugars can drop in less than a hour from 15 to 2 but this doesn't seem to bother the hospital, I had a Hypo while in clinic last time but it has made no difference. What do I have to do to get on a pump?????
 

jopar

Well-Known Member
Messages
2,222
Hi Shell

It does sound as your current clinic isn't helpfull... There is no reuqirement that you have to have attended DAFNE (even tough it's helpfull) before going on the pump, this is a delaying tactic unfairly played...

Check out the NICE guidelines, you don't have to fit all aspects of the criteria set out, and your clinic isn't allowed to pick and choose the parts of the criteria that want either, as a lot can be based around hypo's and quaility of life issues..

You could always opt to go to a more pump friendly clinic if you don't fancy battling your present clinic..

Google INPUT, they will be able to help you with information to what hospitals/consultants in/near your area.. And help you with any problems/battles as well...

I spent almost 3 years building my case when the NICE guidelines were more difficult, on the outset when I first asked my surgery DSN for refferal to the particular consultant(I wasn't attending a hospital clinic at the time) she told me that don't get my hopes up, as they were as rare as hens teeth...

Case building and battles I know a fair bit about...
 

josie38

Well-Known Member
Messages
281
Hi shell,

I got a pump on 23rd Aug and I had to meet the criteria set out by NICE. My experience was a bit long.

I asked about having a pump in July 09 and i had to see the pump therapy team and explain to them how the pump would improve my life. I was told i had to attend a DAFNE/similar course which i did. I had to have 4 HBA1C's done to show that my control was poor. Funding was applied for in May after my consultant decided that it would improve my life and i would have less hypos ( had 20 in the space of 2 weeks at one point). My HBA1C in june was 10.4.

I had to prove that by doing the DAFNE course I could competently count carbs so i had to prove to a consultant, diabetic nurse and dietician (both specialising in pump therapy) that it would show results for me.

It is about the cost as well. The pump i use costs about £2800 and to supply everything for it can cost up to £100 a month and the local Primary Care Trust get to decide if they will you having one but you do have to meet certain criteria to get one.

Wishing you well in getting one.

Josie
 

shell666

Member
Messages
8
Thank you for your input I had an appointment this week at the hospital and have been told I am on the list of people they will discuss at the next pump meeting so I'm crossing everything that things go well for me and I finally get a definitive "YES" OR "NO" :?
 

sugar2

Well-Known Member
Messages
833
Hi Shell,

I got a pump due to multiple hypos throughout the day. I had to be able to carb count, and also show that I was responsible enough to get a pump. :D I also needed to show that I had tried everything I could think of to sort out me BG (which, like you was a HbA1c of 7.4,,,so pretty good according to teh hospital)

I bombarded them with..this is what I have done, and changed this insulin, and tried this regime etc...I think they just got sick of me and gave in.

Having the pump has helped...and I am slowly improving...but do not think that it will solve all you problems...if you haven't tried to sort your control out without a pump, then it is unlikely that havinga pump will change that.

Not saying you haven't tried you iunderstand...but I was curious about something you wrote....dawn phenonomen....and then having to go to bed at 20 to get a BG in the morning that was in range? Have you tried reducing your basal rate, so that you stay more stable overnight....ifrom what you have written, it might be too high? Sure you have looked at this yourself, but might be worth another look?
 

shell666

Member
Messages
8
Thanks for your input sugar2 yes have tried on more than 1 occasion to drop my basal rate but all that does is give me highs during the day, I dropped it last week as per hosiptal instruction and my sugars hadn't gone below 14 so after have a 17.8 while in the clinic I decided to put it back up I only dropped it 1unit as had been on a lower one before and that made me ill. :!:
 

josie38

Well-Known Member
Messages
281
Hi shell

I had similar problems to you where my BS was high in morning even though it was ok during the day. I was sensitive to any change in my basal rateand the slightest difference made me bad for the next few days so i struggled like you.

It took me a year to get my pump and i have only had it a few weeks but it has made a difference to me. I can now have better control of my levels and have more energy.

To sugar2, I used to suffer from multi night hypos and no amount of messing about with basal rates and snacks before bed made any difference. I used have to go to bed high to make sure i had a normal level in morning. Because something hasn't happened to you it doesn't mean that it is not happening to someone else and if you are struggling with control you will do anything to try to change it.


Hope you got a YES shell


josie :) :) :)
 

richieh

Member
Messages
9
Hi,
I having been a diabetic for 30 years and having just been allocated a pump.

The most important thing is to play the game.
You consultant has a budget and x patients they are responsible for.
To get a pump you need commitment from the PCT to allocate £3000 in the first year and then £1000 in subsequent years.

You have to prove why you need it more than anyone else (or that you want it more than anyone else)

I never did the daphne course, what I did was get an Excel spreadsheet and document carbohydrate, doseage and readings Breakfast, Lunch, 2hr post lunch, tea, 2hr post tea and bed.
Be sure to include corrective doseage... this is the selling point as it proves the insulin runs out.

What I proved was that the insulin was not compatible for me.
I demonstrated the same dawn effect you have and how this shouldn't happen as the Lantus was loaded in at bed time and should be peaking at 10hrs

I transitioned onto a split dose of levamir and proved that the background rate was correct over fasting and post 2hr meal marker but the DE was still there. We jiggled times and doses and still couldn't get it right.

The driver for me came when I found the Graphs of absorption which demonstrated that for my dose/kg body weight, the levamir was dead after 16hrs.

This is the fighting ground.
You need to show that not only are you monitoring and managing your condition, you have to be asking them questions... why is it that this occurs?, you tell me not to do this but this is all I can do to maintain a BS of x? have theories and ask them ...is it because?
Show them based on the data of your condition that there are problems at key points in the day, try to prove the insulin is not suitable for you but be able to back it up with independent graphs etc.

Don't be aggressive, you need the consultant to like you and want to put you forward... remember they have to write the report which justifies to a larger panel you are worth the investment

Good Luck
 

shell666

Member
Messages
8
I had an appointment with the lead doctor at the hospital 2 weeks ago and due to the downward spiral my health seems to be on at the moment he said I would be put on the list for the pump meeting that week, I am happy to say I contacted the hospital today and was told I am on the waiting list to get one now, I just hope nothing bad happens between now and March which is when they said the next available space was to have the pump training! I know the pump may not fix all my problems but hopefully it can help with the high background blood glucose levels as obviously the Lantus is no longer working for me, will be seeing someone next week to see if there is a different background that may work better for me? Fingers crossed!
 

richieh

Member
Messages
9
Glad to hear that.

I'm surprised you got it without trying levamir but congrats.

On that note, Levamir with a split dose works quite well as you can ramp it up or back it off for 1/2 the day.... be aware none of these insulins last 24hrs in my experience, but with a split dose you can get pretty clos.e
 

josie38

Well-Known Member
Messages
281
Hi shell

Glad to hear that you have been put on the list.

I agree with richieh...do as the hospital suggest about monitoring and stuff..you may feel like you are jumping through hoops but you may find it worth it in the end.


Fingers crossed for you


Josie :) :) :)