Criteria for a pump

[TallGirl]

Hi All

Does anyone know the criteria for being approved to have a pump please?

I'm a type 1 and my HbA1C has been hovering at around 9.5 for the last year or so.

My problem is that I eat constantly, like every hour! :shock: and so that's a lot of injections that I have to do (which causes the insulin to stack and my BS's to plummet) or I just wait and do one injection to cover what I've eaten over the last few hours which of course causes high BS's

I was wondering the if the pump may be suitable?

 

[ams162]

hi

i dont know the criteria we just asked our DSN for one she said we would benefit from one but that we had to have completed a carb counting course even tho we already carb counted and then it was just waiting for the funding

anna marie

 

[catherinecherub]

There are some useful links in this thread,
viewtopic.php?f=14&t=20039

 

[TallGirl]

hi

i dont know the criteria we just asked our DSN for one she said we would benefit from one but that we had to have completed a carb counting course even tho we already carb counted and then it was just waiting for the funding

anna marie

I've already done the DAFNE course and it works for me, but only if I cut right down on the frequency that I eat

 

[iHs]

Hi

Is there a reason for you eating like you do or is it because you enjoy food?

 

[TallGirl]

Hi

Is there a reason for you eating like you do or is it because you enjoy food?

Hi

I suffer from anxiety and possible depression so that may play a factor. I definately eat more when I'm at work as well

But I do enjoy my food! (Luckily, I've never had a problem with my weight though!)

 

[ebony321]

Hi,

A pump may surely help, but it works with the same concept as injections, you couldn't have boluses of insulin very often as you may still suffer from the 'stacking effect'

It would help with highs and lows, but only if you curbed your eating habits i'm afraid.

How about having carb free snacks inbetween meals, or having one carby snack a day, then throughout the day when you feel like snacking eat things that won't affect your BG's so much.

Your hba1c is high to qualify for a pump, and you have also have done the DAFNE course which some hospitals say is a requirement.

To be bluntly honest, it will be hard to get good control pump or not with those eating habits, maybe you should tackle those first, then get a pump, as you do qualify but it would be a shame to get a pump, and it not work for you and cause distress and unhappiness as a result.

You should talk to your consultant or specialist to find the best option for you

Hope all works well for you whatever you decide to do

 

[TallGirl]

Hi,

A pump may surely help, but it works with the same concept as injections, you couldn't have boluses of insulin very often as you may still suffer from the 'stacking effect'

It would help with highs and lows, but only if you curbed your eating habits i'm afraid.

How about having carb free snacks inbetween meals, or having one carby snack a day, then throughout the day when you feel like snacking eat things that won't affect your BG's so much.

Your hba1c is high to qualify for a pump, and you have also have done the DAFNE course which some hospitals say is a requirement.

To be bluntly honest, it will be hard to get good control pump or not with those eating habits, maybe you should tackle those first, then get a pump, as you do qualify but it would be a shame to get a pump, and it not work for you and cause distress and unhappiness as a result.

You should talk to your consultant or specialist to find the best option for you

Hope all works well for you whatever you decide to do

Thanks for the reply

I've got an appointment with a diabetic consultant and a diabetic nurse in a couple of weeks so I'll have a chat and see what they suggest (I usually just see one of the nurses at my GP surgery)

What sort of low/no carbs snacks are there? Is it things like meat and cheese etc...

 

[iHs]

Hi All

Does anyone know the criteria for being approved to have a pump please?

I'm a type 1 and my HbA1C has been hovering at around 9.5 for the last year or so.

My problem is that I eat constantly, like every hour! :shock: and so that's a lot of injections that I have to do (which causes the insulin to stack and my BS's to plummet) or I just wait and do one injection to cover what I've eaten over the last few hours which of course causes high BS's

I was wondering the if the pump may be suitable?

Hi

To prevent insulin stacking can you not inject slightly more bolus at BR and Lunch and then your bg levels would be lower mid morning and mid afternoon and so you would be able to eat a small snack and not have to bolus for it? This is much better than injecting for every bit of food that you want to eat. You would just have to bolus 3 times a day instead of 5 or 6.

 

[sugar2]

carb freee snacks. I ma sure they are loads, but the ones that apeal to me are celery, melon adn sugar free jelly. Have you tried the sugar free gum? I just wondered if this might work instead of a snack?

 

[imalittlefishy]

I too am a frequent snacker and use a combination of things to try to get around it without insulin stacking...as suggested above, either injecting a little more at meal times so it's ok to have a carb-y snack a few hours later, or carb free snacking too...I'm a big fan of cheese, salad, sugar free jelly...harder to think of now but I'm sure there are more I'm also someone who can get away with eating fruit without spiking as long as I keep it to small amounts so I do tend to munch on that throughout the day as well, doesn't work for everyone though!
xx

 

[donnellysdogs]

The NICE guidleines are the ones you need to look at regarding the criteria for a pump-i.e. qty of hypo's/hypers/tried varying MDI's/impact of MDI on life etc.... some hospitals are fantastic with helping people on to pumps, but some aren't......I don't understand why the variances are so huge between hospitals and consultants etc

 

[ebony321]

Hi,

A pump may surely help, but it works with the same concept as injections, you couldn't have boluses of insulin very often as you may still suffer from the 'stacking effect'

It would help with highs and lows, but only if you curbed your eating habits i'm afraid.

How about having carb free snacks inbetween meals, or having one carby snack a day, then throughout the day when you feel like snacking eat things that won't affect your BG's so much.

Your hba1c is high to qualify for a pump, and you have also have done the DAFNE course which some hospitals say is a requirement.

To be bluntly honest, it will be hard to get good control pump or not with those eating habits, maybe you should tackle those first, then get a pump, as you do qualify but it would be a shame to get a pump, and it not work for you and cause distress and unhappiness as a result.

You should talk to your consultant or specialist to find the best option for you

Hope all works well for you whatever you decide to do

Thanks for the reply

I've got an appointment with a diabetic consultant and a diabetic nurse in a couple of weeks so I'll have a chat and see what they suggest (I usually just see one of the nurses at my GP surgery)

What sort of low/no carbs snacks are there? Is it things like meat and cheese etc...

Yeah, things like meat and cheese, small pieces or fruit, sald.. maybe a handful of nuts. if you're a fan of salad you can dip carrot sticks or cucumber sticks in sour cream or something like that!

Your consultant may be able to give you more ideas how to handle snacking a bit better without having lots of injections.

Having extra insulin to cover a snack later might work! just remember to have the snack you intend to :lol:

if you work with DAFNE rules, 10g or carb will usually raise you BG by 3mmol, so if you test before you snack, you could have a small snack and probably get away with no bolus injection.

Sometimes when i walk my dogs, instead of reducing my basal rate on my pump to account for the exercise ill take a small snack instead. Takes practice to know how much though

good luck!

 

[donnellysdogs]

The Roche magazine (Reach) this month has an article on pump therapy giving details of what is considered to be the necessary requirements to have a pump, and the steps to take to get one...much of what has been said on forums here.....but hopefully som HCP's may get copies of these mags from Roche!!!

 

[cugila]

catherinecherub posted a link earlier about the criteria but it seems to have been overlooked ?

Here again is the current NICE guidelines regarding the criteria for obtaining a pump :

“Continuous subcutaneous insulin infusion (CSII or ‘insulin pump’) therapy is recommended as a treatment option for adults and children 12 years and older with type 1 diabetes mellitus provided that:

Attempts to achieve target haemoglobin A1c (HbA1c) levels with multiple daily injections (MDIs) result in the person experiencing disabling hypoglycaemia. For the purpose of this guidance, disabling hypoglycaemia is defined as the repeated and unpredictable occurrence of hypoglycaemia that results in persistent anxiety about recurrence and is associated with a significant adverse effect on quality of life

OR

HbA1c levels have remained high (that is, at 8.5% or above) on MDI therapy (including, if appropriate, the use of long-acting insulin analogues) despite a high level of care.

The links are all available in CC's previous post......