Type 1 Please I want your answers in regards to Insulin pumps and the access to them.

[Olihill99]

@Olihill99 To build on what others have said above, I think you need to remember first that not only do you need to provide evidence of motivation to use a pump, but also practical evidence that you have the skills to insert, calibrate, understand all the settings, have attended a DAFNE course, etc and do so on an ongoing basis to qualify for both a CGM and a pump. Also pump prescriptions are currently only done from hospital endocrinologists, so it is your hospital diabetes centre that you need to lobby - GPs & DSNs cannot dispense pumps to my knowledge, though their support is also useful. Sadly all CCG budgets are under severe stress, some more than others.

BTW please don't give up on exercise - have you tried weightlifting/resistance work - for most people this causes a transitory rise in BGs, but is best for building maintaining muscle.

Hey yeah I try give them plenty of prove I try ask a lot of questions to understand the pump they think I think the pump is some great device that will allow me never to worry about my diabeties again .. I know the pumps are a lot of work I just need to convince them I will be okay on it . And no I haven’t I used to run a lot so would you suggest weights are the best ? Thanks

 

[Juicyj]

Hi @Olihill99

I run and also use a gym, there are strategies you can employ to manage any type of exercise, but if you're starting out again since your diagnosis then of course it will be trial and error, confidence does improve massively once you start to grasp what works. However my biggest tip is to start and exercise with no quick acting insulin on board and aim to start with your BG levels above 9 so you have a buffer if they drop, start with 15-20 min runs and build from there. Personally I find mornings are the best for running as I am more insulin resistant so rarely go low on a 30-40 min run. Always carry glucose in an easy to consume format, glucogel, glucojuice, jelly babies and if you use strava then use the beacon to alert others where you are too.

 

[Olihill99]

I’m think of just doing weights to start to be honest because I’m nervous about a long run used to do loads and I’m a skinny lad so think my sugars would just plumit , what would you suggest for a start of at home like what setup so I know I’d be safe then I can progress to gym.

 

[derivadow]

Hi @Olihill99,

I recently moved from MDI to a pump (Medtrum Nano), hopefully some of this is of some informative...

Firstly in my experience being on a pump has improved my BG control and generally it is a very 'good thing' - the biggest thing for me - I can now sleep through the night (mostly) + I can exercise with less planning and without needing to manage it via sugar (i.e. I can drop my basal vs eating). But it isn't a silver bullet.

I'm not on a closed loop - but even if I were it isn't something that you can 'set and forget'... pumps get blocked, they sometimes fail, you still need to pre bolus and carb count, you still need to adjust for exercise, you still need to run fasting tests to calculate your basal rates and get you i:c sorted (FWIW I have multiple basal rates for different circumstances (depending where on my body the pump is, for when I'm ill, when I'm exercising etc. etc.)), pumps also come with some extra decisions: because you change them every 3 days I try to consider where I'm going to be in 72 hours... plan for what to do if you're out and the pump fails (replace it or switch to MDI)... contact sport presents a new set of challenges (I'm too old now but would have mattered if I were younger!)...

None of that is to say they aren't great - they are - but money aside in my experience I suspect they aren't for everyone (FWIW for a longtime I didn't want one because I didn't want to relinquish control of something that could kill me to software) and they aren't effort free. They give you better control because you have more control/ more options but you need to do a bunch of stuff to understand how to benefit from all of that.