Type 1 Getting a T-Slim & Dexcom in the UK

Maz_1

Member
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13
I am a newly diagnosed type 1 (its been about a month). I'm having loads of hypos and really struggling with getting any help from my gp and diabetes nurse. I haven't even seen a endo yet... They say its going to be at least another month or so until I can see one and then i'll have to wait at least 6 more months till I can even speak about getting an insulin pump. Does anyone have any tips on speeding this process along? Also are the tslim and dexcom available in the uk on the NHS?
 

Muneeb

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428
Type of diabetes
Type 1
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Insulin
As you are newly diagnosed, and are having lots of hypos I would reduce your insulin usage. You really need to do a basal test, and then calculate your carb ratio. Hypos for anyone on insulin are inevitable, but you can manage these much better if the control is better (and they will be less severe).

Are you having hypos mainly after using fast acting? or after using long lasting (I assume you are on a basal/bolus setup - correct me otherwise).

In regards to pumps, I have never had one as MDI's work great for my lifestyle, but you have to meet certain criteria before you are eligible. The type of pump will also depend on the funding in the area. But I'm pretty sure unless its exceptional circumstances dexcom is not available on the NHS, the libre is, but again you have to meet specific criteria.

Either way I think the most important thing for you is to understand as much as you can about food, nutrition and medication as this will only help whether you are on injections or a pump.
 
D

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Welcome to the club @Maz_1
You have obviously been doing a lot of research in the last month if you have already chosen your pump and CGM.
However, a pump will not stop hypos and, whilst a CGM will tell you are having a hypo, it too will not stop them.

It is currently, very unusual in the UK to get a pump when you are first diagnosed and CGM prescriptions are even more rare.
I agree with @Muneeb - learn the basics about food, etc. so you are armed with the knowledge to manage your diabetes, iniyially with injections and later with a pump.

If you want to trial CGM-like technology. The current cheapest CGM-like option to self fund is the Libre. It does not alert but it gives a good insight into what is happening between finger pricks. Be aware, it is not as accurate.
If you want to learn more about insulin dosing, you could do the bertie online course.
 

Juicyj

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Hi and welcome @Maz_1 :)

Put a call in today and ask to speak to a diabetic nurse, as your newly diagnosed, avoiding hypos and reducing your insulin is a priority so get someone to call you back, advise them that you're having lots of hypos, so you should speak to someone fairly quickly.

Have you done any research into pumps ? Unfortunately using a pump isn't a magic wand to good control, you need to learn the basics first which is managing your glucose levels to adjust insulin and carb counting for your insulin doses, also you may be experiencing a 'honeymoon phase' which we get after diagnosis, it's a temporary phase where the pancreas is less stressed and produces insulin again, it can play havoc with your control and personally I was relieved when it was over.

There isn't a way to speed up the process for gaining access to a pump and you need to meet NICE criteria for funding, they're not given out to everyone, it also depends on your CCG's policy with funding, also with pump availability as it varies throughout the country. Some CCG's will fund the libre and some like mine don't, I self fund the Dexcom G6 at £159 a month, it's a commitment to fund this but for peace of mind to me it's worth it.
 

Maz_1

Member
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13
Hello @Maz_1 Welcome to the forum, have a look on the main page there are links there about T1 giving you some info which may or may not be helpful.

Don't know about pumps I'm afraid not some thing I have as for the Dexcom no it is currently not available on the NHS only Abbotts Libre is available but that is not a CGM you need some extra bits to make it so however Libre 2 should change that, maybe, but that is not going to be available in this country till next year, depending on several different sources.

Hypos are bad when your not used to them :(


Hey thanks for your reply,

I am actually on the libre and have been pretty much since I was diagnosed. Not self funded but NHS. My Dr just gave me one... Since reading up on it, it seems like it's almost impossible for most people to get?? Seems I got lucky! Yes the hypos are bad, much worse in the night. Currently my levels are really high I just got back from Dubrovnik and now I'm worried the insulin I took has lost effect due to heat damage. Is there any way I can test this theory? Worried about my basal dose in particular as I took it lastnight and according to my libre it did literally nothing. I also have a chest infection so maybe that is why?? Ughhh
So many factors to consider.
 

Diakat

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Call your team about the hypos. Replace the “possibly faulty” insulin. You are trying to run before you can walk, it is great that you are researching pumps etc but at the moment your head is so full of various possibilities that you are not dealing with the basic issue.
Have you been taught to carb count and adjust doses yet? As that is fundamental for management (and potential future pumps).
 

Maz_1

Member
Messages
13
Hi and welcome @Maz_1 :)

Put a call in today and ask to speak to a diabetic nurse, as your newly diagnosed, avoiding hypos and reducing your insulin is a priority so get someone to call you back, advise them that you're having lots of hypos, so you should speak to someone fairly quickly.

Have you done any research into pumps ? Unfortunately using a pump isn't a magic wand to good control, you need to learn the basics first which is managing your glucose levels to adjust insulin and carb counting for your insulin doses, also you may be experiencing a 'honeymoon phase' which we get after diagnosis, it's a temporary phase where the pancreas is less stressed and produces insulin again, it can play havoc with your control and personally I was relieved when it was over.

There isn't a way to speed up the process for gaining access to a pump and you need to meet NICE criteria for funding, they're not given out to everyone, it also depends on your CCG's policy with funding, also with pump availability as it varies throughout the country. Some CCG's will fund the libre and some like mine don't, I self fund the Dexcom G6 at £159 a month, it's a commitment to fund this but for peace of mind to me it's worth it.

Yes I have done loads of research on pumps, carb counting and the honeymoon phase - I feel like no matter how much I read, when it comes to the situation at hand its still a bit of a trial and error thing.
Regarding insulin pumps at first I was thinking of the omnipod, but the dexcom and tslim work together to keep your levels stable (especially in your sleep when you cant monitor it yourself). This is why I am interested in getting an insulin pump ASAP - I feel like it will help.. Also I HATE (as im sure most people do) jabbing myself 5+ times a day (currently I am trying the I-port but not sure if its working).
I definitely thought I was doing alright with the carb counting the last 2 weeks, it was mainly the night I was having random hypos then my levels would be stable again. I went to dubrovnik for 3 days this weekend (it was SO hot) and also got a chest infection while I was there so since then ive been struggling to get my levels down. Lastnight I gave myself my basal dose and ive woken up and my levels went up (went to sleep at 7.8mmol and it went up to 13). Could my insulin be heat damaged or am I just not taking enough due to my chest infection?
BTW I have a libre sensor which I was given pretty much right away, seems like I was lucky in that respect!
 
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MeiChanski

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Type of diabetes
Type 1
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Insulin
Yes I have done loads of research on pumps, carb counting and the honeymoon phase - I feel like no matter how much I read, when it comes to the situation at hand its still a bit of a trial and error thing.
Regarding insulin pumps at first I was thinking of the omnipod, but the dexcom and tslim work together to keep your levels stable (especially in your sleep when you cant monitor it yourself). This is why I am interested in getting an insulin pump ASAP - I feel like it will help.. Also I HATE (as im sure most people do) jabbing myself 5+ times a day (currently I am trying the I-port but not sure if its working).
I definitely thought I was doing alright with the carb counting the last 2 weeks, it was mainly the night I was having random hypos then my levels would be stable again. I went to dubrovnik for 3 days this weekend (it was SO hot) and also got a chest infection while I was there so since then ive been struggling to get my levels down. Lastnight I gave myself my basal dose and ive woken up and my levels went up (went to sleep at 7.8mmol and it went up to 13). Could my insulin be heat damaged or am I just not taking enough due to my chest infection?
BTW I have a libre sensor which I was given pretty much right away, seems like I was lucky in that respect!

Did you finger prick to confirm it was a hypo or your libre showing it was a hypo?

It’s what we are saying, you have to be educated to some level. Even wearing a pump in hot weather stops the insulin working as well.
Pumps selection depend on what area in England and Wales you are in. You can’t walk into a hospital and say you want a Tandem. Some CCGs only have one pump choice.
Chest infection can affect your levels and heat can damage your pens if you are walking around with it above room temperature.
Type 1 diabetics are taught how to store insulin ans how to look after ourselves during illness. So we need you to contact your team to adjust your insulin to make it work.
Carb counting for a pump - you need to do a carb counting course such as DAFNE. Or whatever course your hospital is providing. Then you have to wait 6 months before being considered for a pump.
 
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Juicyj

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I agree with @Knikki it's more than likely the chest infection is pushing your levels up, infection is a pain to deal with with taking insulin as our bodies produce glucose in response to fighting infection that's why understanding 'sick day' rules is important and knowing what correction dose to administer based on your levels is part of this.

As also mentioned a pre-requisite to getting pump access is having done the DAFNE (Dose Adjustment for Normal Eating) course is necessary, this is an important course which covers everything insulin dependent diabetics need to know, it also proves to your team your knowledge is there, unfortunately the NHS don't hand pumps out, it's a cost, so ensuring you've met all the criteria first is vital.

I do admire you for getting clued up, it's vital to know as much as you can, it's your health ultimately that counts and knowledge is power, as t1 isn't going to disappear anytime soon so learning how to adapt and live with it so it doesn't impact on your life is the key, get a copy of 'Think like a pancreas' written by a t1, it's a great read.