Can you qualify for a pump if you don't have bad control?

[goji]

Hi

I'm just wondering if there is any way to have a pump if your control isn't that bad and you don't have lots of hypos?

My Hba1c is usually between 6.6% and 6.9% so not what they would consider 'poor control', however I take around 9-11 injections a day in order to get that level.

I can't really function on fewer shots as I need insulin any time I eat (and I eat more than 3 times a day) plus two shots of basal.

Thanks
G

 

[Riri]

Re: Can you qualify for a pump if you don't have bad control

Hi G. Theres a link to the nice guidelines below which may give you more information. What I don't know is how much flexibility there is then locally to 'work within/around' these. For me it wasn't that my control was particularly bad on the surface (hba1c around the 7.5 mark normally) it was a combination of things - extreme fear of hypos and on MDI and lantus I was frequently getting them at night and out of the blue. My sleep patter was serverly disrupted because of this and this had a knock on effect. I was then getting extreme morning highs and no amount of adjustment to my injection regime, including a switch to Levermir, solved this problem. I did try for about 6 months before I was recommended for a pump.

http://guidance.nice.org.uk/TA151

 

[jopar]

Re: Can you qualify for a pump if you don't have bad control

Your case would be around based on Quality of Life issues..

Which is around the amount of injections you are having to do every day to maintain control..

So you've got time consuming, to check bg to adjust insulin,
The impracticability and disruption involved in routine to carry out necessary injections..

To underpin this, if you can say why you need to carry out this amount of injections to maintain control, and how a pump can be used to over come these problems.

Have you got Dawn Phon?

Where you have to counter react the effects that your background can't deal with on a single/2 injections a day with quick acting insulin..

Are you particularly sensitive to insulin, that really needs the pumps ability of fine dosing more practical..,


When control is good, so you looking at quality of life issues, it can make access to a pump more difficult but not impossible to get funding.

 

[goji]

Re: Can you qualify for a pump if you don't have bad control

Thanks very much for this information - it is really helpful. Glad to know that a good hba1c doesn't necessarily rule it out (albeit it's more difficult to qualify).

My main reason for thinking about the pump is that I have Addison's. The hydrocortisone I take (4x per day) is short acting but leads to daily spikes in my BG which can't be accounted for by food.

I heard from others (with diabetes and Addisons) that it can be easier to keep control on a pump (covering the steroid-induced spikes in BG) and less hassle (in terms of a couple of infusions per week rather than the 70-80 injections I do a week).

As I take large numbers of pills a day (for Addison's and my other conditions) the hassle of the endless injections can sometimes feel like a lot to deal with (though I feel like I shouldn't complain - lots of people have it worse! ).

I am relatively sensitive to insulin - I use a children's novopen for the half units.

My warning signs are still good so I can catch a drop when my BG gets to about 3.8 - 4. I've never been in a position where I needed assistance.

I don't have a dawn phenomenon as I don't make any cortisol - my BG at waking is always around 4 - 4.5!

I'm not under a diabetes clinic though - the last time I went to one a few years ago, my hba1c was 6.4% so they said the diabetes was well controlled and discharged me back to GP care. As they don't see me as a 'problem' patient I suppose I would have to fight hard to qualify.

Also do any of the things I'm saying suggest a pump would actually be beneficial to me? The diabetic addisonians (who recommend pumping) are overseas where I think pumps are more of a standard thing - here it seems like they only give them to people who would truly benefit.

 

[jopar]

Re: Can you qualify for a pump if you don't have bad control

Yes if you've got addisons disease as well as diabetes, the pump makes perfect sense... As it would enable you to quickly change your needs, and better deal with the impact that your addisons can have on your bg's..

You need to get your gp to refer you back to the consultant

But I would also have a word with your addison's consultant hopefully s/he might back you up with a need of a pump...