Advantages/Disadvantages pump

[Fern Hopper]

As a type 1 for 57 years I have recently been told that I don't qualify for a pump because I am too well controlled. My HbA1c is 37.
I actually am wondering whether to ask again. What advantages/disadvantages might I find?
Not too keen to have one attached abdominally as I have quite a few scars from cancer treatment.
How do you program a patch pump? Do you need a phone with you at all times?

 

[EllieM]

Hi @Fern Hopper do you get a lot of hypos? That is why I have been offered one but as I haven't been given a training date yet I don't know whether I'll find it an improvement.

 

[Fern Hopper]

I don't really have many hypos. I have always had a low HbA1c. But I would have thought after 57 years.....

 

[EllieM]

I don't really have many hypos. I have always had a low HbA1c. But I would have thought after 57 years.....

There is an interesting article here

Can I get a hybrid closed loop system on the NHS?

On December 19th 2023, the National Institute for Health and Care Excellence (NICE) shared the final guidance which recommends hybrid closed-loop systems for certain people living with type 1 diabetes in England and Wales.

www.diabetes.org.uk

Sounds like they are prioritising pregnant women and children.
And if you aren't a child or planning to get pregnant you need to meet the following criteria

They should already be using at least one of either an insulin pump, CGM or Flash and have a HbA1c above 58 mmol/mol (7.5%) or experience disabling hypos. Disabling hypos are defined by NICE as “when hypoglycaemia occurs frequently or without warning, so the person is constantly anxious about having hypoglycaemic episodes”.

We estimate that the current recommendations would apply to over half of people with type 1 diabetes in England, and there is further opportunity to review the guidance in the years following publication.

An hba1c of 37 after 57 years and no serious hypos is outstanding control, in my opinion. (Though I appreciate that it may seem unfair that you don't get one after 57 years.)

 

[Fern Hopper]

Thanks for that. Plus I am not too sure I would find one any particular advantage.
I suppose the only time a pump could be an advantage when running Parkrun as my BG always spikes.

 

[Chas C]

Wow an HBA1c of 37 is amazing with very few hypo's, I think I hit that in one year, it was very very hard work but now at 39. I've been IDD for 53 yrs, so a few behind you.

If you do not have meal time or night time (dawn phenomenon) issues it might be that a pump would cause you more distraction. It normally takes few months to settle down pump settings, but likely you'll be quicker due to your already good control.

It might help with activities but have to say I find I have issues too with high BG's after exercise and a pump, likely due to the body releasing stored carb's in muscles/adrenaline etc. Controlling going low is easier being able to set pump to activity mode (or turning basal off), but post exercise highs don't seem to be much better. BTW for me a high is above 10, so range is maybe up to 14 ish.

I cannot help with patch pumps and control (remote etc) as I'm on tubed, I don't need a phone with me but I take one so I can see BG's on my watch.

 

[Tonycoia]

Does anyone have real bad issues with pump falling off due to work. I have manual job and train a lot . It’s doing my head in

 

[type1since82]

Does anyone have real bad issues with pump falling off due to work. I have manual job and train a lot . It’s doing my head in

Make sure to use rubbing alcohol when you put the pump on. There is also a sticky like prep wipe you can get which helps the tape adhear better but I've found also if sweating due to like factory work makes it worse but try waterproof tape around the tape they give with the pump. I found that putting them in my back above the pant line works better for me. I have a Medtronic Minimed pump for 23 years now

 

[Hopeful34]

Hi @Tonycoia welcome to the forum. Which pump are you using?
Skin tac wipes/lotion or Tegaderm film are useful for keeping infusion cannulas in place. If you use Skin tac, you also need something like Lift off when removing the cannulas as they stick to your skin really well.

Edited to add, would you like a moderator to move your post to a new thread, so it doesn't get 'lost' amongst this one?

 

[Tonycoia]

Hi @Tonycoia welcome to the forum. Which pump are you using?
Skin tac wipes/lotion or Tegaderm film are useful for keeping infusion cannulas in place. If you use Skin tac, you also need something like Lift off when removing the cannulas as they stick to your skin really well.

Edited to add, would you like a moderator to move your post to a new thread, so it doesn't get 'lost' amongst this one?

Omnipod5

 

[Fern Hopper]

Endocrinologist appointment last week. As I expected and suspected I am not going to get a pump. Too well controlled and far too fit, apparently. Endocrinologist was surprised that I had been referred. I must change my behaviour - exercise less and eat more.

 

[hh1]

I saw my consultant a couple of weeks ago. T1 for 40 years and for the first time ever, over the past year I've started to experience dawn phenomenon, so I asked him about this. He told me the best solution would be a pump, and that it was hoped that in five years or so all T1s would have access to that if they wanted. However, a the moment he's very happy with my figures so there's no chance. I'm equally not sure I'd want one; the thought of all the programming and setting up fills me with horror; sounds all too easy to mess it up! I realise it's a godsend for some people, it's just we're all different (and long may that be the case). For me it's enough to have a Libre stuck on 24/7/365; the thought of another gizmo as well doesn't do it for me.

 

[Fern Hopper]

I don't see a diabetic consultant, I'm pleased to say.
There is some money available where I live. I was told this by a local GP that I run with.
I think I'll leave this as it stands.

 

[Adeel M]

Unfortunately if your HBA1c is good it normally means no pump. That said it also depends on the funding available in your local area, you mentioned you don't see a diabetic consultant, it is worth seeing to see if it is something they maybe able to put you onto a waiting list for. Final point, do you really need a pump if your HBA1c is good? It works wonders for people like myself who have morning highs or don't control their sugar levels well. The advantage is you don't have to keep taking injections, disadvantage is having something stuck on you all the time, for some it works well and they get used to it, for myself I'm still trying to get used to it.

 

[Adeel M]

Does anyone have real bad issues with pump falling off due to work. I have manual job and train a lot . It’s doing my head in

I'm assuming you are already using the sticky adhesive things that you can place over your omnipod? this helps keep the pod on, maybe look at try using different sites, when I play football it comes off or really hurts when I put the pod on my thighs, but fine on my stomach or arms. Last but not least, trim the hair on the area you will be placing the pod onto and the sticky adhesive overlay if you use them, this will help keep it on longer.