I have not been at all keen to switch from mixed to the basal/bolus regime as the idea of carb counting and injecting 5 times a day is a bit off putting. However, I'm now realising I do have restrictions in order to keep my bg levels within my target (no less than 5 and no more than 9). My hospital is not a DAFNE centre, so I have no access to the course, but could my DSN swap me over without me doing the course? Lastly, could I be given a pump to avoid the multiple injections per day or would I have to wait ages for one?
Thanks Noblehead for the info. Something for me to think about.Yes they can swap you over without doing the course June, the pump would be another option and you would have to discuss this with your diabetes consultant.
Some hospitals have their own in-house version of the DAFNE course, but don't forget there's some good on-line carb counting courses like BDEC which are extremely good by all accounts:
http://www.bdec-e-learning.com/
Oh dear, this is putting me off a pump, but I don't want to inject 5 times a day. I think the expression is "between a rock and a hard place"Carb counting isn't difficult to learn and is probably important for everyone on insulin. If you are using a mixed insulin, it will work better with a consistent carb intake and you can't work that out without carb counting to a degree.The BDEC course goes further and teaches you to make adjustments to basal and bolus insulins
re pump
I know some of the consultants are quite liberal in the way they interpret NICE pump guidelines (and some ultra strict by all accounts) so from what I see on this forum , pump availability seems to be dependent upon where you are. However, the guidelines actually mention having been using MDI as a condition. https://www.nice.org.uk/guidance/ta151
Also as a pump user, I would point out that there is actually a bit more 'maintenance' required with a pump (frequent testing, changing of reservoir, cannula etc) Also, after almost 7 years pumping, I still find the actual insertion of the cannula far more daunting than injecting.
.
Have just read through the NICE blurb and I don't think I'd be offered a pump as I have my bgs well controlled and have only had one mild hypo (so far). I just don't fit the criteria unfortunately. I can also understand the reluctance to offer a pump as I had no idea they were so expensive. I appreciate the NHS is not there to make my life easier, (avoiding MDI), but just keep me alive.Carb counting isn't difficult to learn and is probably important for everyone on insulin. If you are using a mixed insulin, it will work better with a consistent carb intake and you can't work that out without carb counting to a degree.The BDEC course goes further and teaches you to make adjustments to basal and bolus insulins
re pump
I know some of the consultants are quite liberal in the way they interpret NICE pump guidelines (and some ultra strict by all accounts) so from what I see on this forum , pump availability seems to be dependent upon where you are. However, the guidelines actually mention having been using MDI as a condition. https://www.nice.org.uk/guidance/ta151
Also as a pump user, I would point out that there is actually a bit more 'maintenance' required with a pump (frequent testing, changing of reservoir, cannula etc) Also, after almost 7 years pumping, I still find the actual insertion of the cannula far more daunting than injecting.
.
Have just read through the NICE blurb and I don't think I'd be offered a pump as I have my bgs well controlled and have only had one mild hypo (so far). I just don't fit the criteria unfortunately. I can also understand the reluctance to offer a pump as I had no idea they were so expensive. I appreciate the NHS is not there to make my life easier, (avoiding MDI), but just keep me alive.
Life's not fair is it?Hereby lies the irony with me too..
I was given in my youth the "if your a good boy with the diabetes." Blah blah. "they're developing this bionic pancreas pump." Blah de blah. "Maybe even a transplant.!!?" Blah blah blah.. "So keep yourself healthy.... And...." Yes, and....
More bemused by it than anything else..
The injections never bothered me.. Still hypo aware. & I pass up on the sweets offered round..
The future is now. & I guess not everybody gets to ride the "hover board."
Have just read through the NICE blurb and I don't think I'd be offered a pump as I have my bgs well controlled and have only had one mild hypo (so far). I just don't fit the criteria unfortunately. I can also understand the reluctance to offer a pump as I had no idea they were so expensive. I appreciate the NHS is not there to make my life easier, (avoiding MDI), but just keep me alive.
Will do.
When I'm feeling a bit better I will mix the rest of the Lindt with some hot cream and make my own truffles.
Don't like to throw things awaywell not food anyway!!
Just to emphasise it does depend on where you live , some consultants are far more proactive and enthusiastic about pumps than others . So for those that do want them, they may find that there is some flexibility in the interpretation of the guidelines. I know people who have changed clinics and then been able to obtain a pump.
( I live in France so no NICE guidelines but the doctors make similar judgements I got one because I did a lot of exercise and found it hard to stop low levels when exercising. I wasn't scared of them because I could treat them quickly. One could say that they did impact on my lifestyle. I certainly know of people in the UK who have been able to obtain pumps under similar circumstances.)
I've come up with, I think, a good reason for having a pump. I babysit my grandson aged 3 years, 3 times a week. Sometimes this clashes with an insulin injection and I have to retreat to the bathroom to inject as I don't want him to see me sticking a needle in my tum. This is not an ideal situation when responsible for a toddler who can get up to mischief in a second. They need to be watched at all times. If I went over to MDI, this situation would only get worse. Maybe this might be a good reason for having a pump. It's a thought, but perhaps I'm being too optimistic.June, there's many on the forum who have good diabetes control and still been put forward for a pump, there was a guy on the forum around two years ago (who had an Hba1c in 4's) and he still moved over to pump therapy because his present insulin therapy was effecting his quality of life (and his consultant agreed that a pump would improve it), so don't dismiss the possibility that a pump might not be offered to you now or in the near future as quality of life is a big consideration when consultants are accessing a patients suitability for a pump.
Thanks for that. I shall now go to bed depressedNotmally they would want you to have tried all methods of insulin and still no improvement in control. I do no somebody that went straight from mixed insulin to a pump though but had a battle initially as the consultant didn't want him to have one but the DSN thiught it would help. He had never counted carbs in over 35 years as a T1, so had to do a carb counting course first.
Mums also have to inject in fromt of their children etc so may not be a valid reason.
Thanks for that. I shall now go to bed depressedI think I may stick to the mixed insulin and live with the restrictions.
We use cookies and similar technologies for the following purposes:
Do you accept cookies and these technologies?
We use cookies and similar technologies for the following purposes:
Do you accept cookies and these technologies?