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Eligibility for closed loop system

Dillinger

Dillinger

Well-Known Member
Messages
1,209
Location
London
Type of diabetes
Type 1
Treatment type
Insulin
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Celery.
Hello,

Has anyone been prescribed a closed loop system when they are not strictly within the eligibility criteria?

In particular if your HbA1c is better than 58 mmol/mol.

Does anyone have experience of what “disabling hypoglycaemia” means in this context?

Would that be a single hypo in which you needed help from someone else or a regular pattern of them?

Eligibility details here:

NHS England » Hybrid closed loop technology

Hybrid closed loop (HCL) systems link continuous glucose monitoring (CGM) with insulin pump technology to monitor blood glucose and automatically adjust the amount of insulin given through a pump to people living with type 1 diabetes. HCL can eliminate finger-prick tests and prevent...
www.england.nhs.uk www.england.nhs.uk

Thanks!
 
I cannot answer the first part of your question as I was part of the trial for Hybrid closed loop and my HbA1c was embarrassingly much above 58, however, in layman's terms disabling hypoglycaemia is just a fancy way of saying hypo's that are unpredictable and can result in anxiety about recurrence and affects your quality of life. My original petition by my diabetes team for me to get an insulin pump was not only due to dawn phenomenon but also due to "disabling hypoglycaemia", even with minimal basal (we're talking 4 or less units) overnight I was low for the entirety of the night and never woke up during these periods which affected me and my quality of life.
 
Thanks Nicola,

Were you on a glucose monitor so you could demonstrate that or was it your own experience of it?
 
Dillinger said:
Thanks Nicola,

Were you on a glucose monitor so you could demonstrate that or was it your own experience of it?
Click to expand...

Pre-having CGM's through the NHS my team provided me with one for the week. They downloaded the data after the week which showed lows all night and given that my blood sugars in the morning with a fingerprick were always 4.5 mmol/mol or below and I felt almost drowsy/out of sorts it was concluded that the results from the CGM were more than likely not compression lows and actual results. This data was used as evidence to show to the board of people who decide who gets a pump.

Edited to add information.
 
I qualified for pump but not CGM but the nurse overrode the consultant and issued CGM

So it is possible but I think it comes down to do the have the money and is there someone that either cares or is willing to issue the kit
 
It very much depends on a few things aside from NICE criteria, relationship with DSN/Consultant is very important as these are the gatekeepers and if they know you well, happy to support you then they can help define your case for pump eligibility, a point that's rarely considered with T1d management is how the condition affects your quality of life, if it is preventing you from doing certain things such as exercise, ability to work as examples then these are also important criteria, however with all this being said Partha Kar's vision is to allow access to all T1d's for hybrid closed loop systems - which then highlights affordability as each trust only has a certain amount of budget to fund this tech and so then relationship with DSN/Consultant is again vital as they will indicate timing of this happening.
 
Careful with exaggerating hypo unawareness, it'll effect your driving license. My management was good, but the stress and sleeplessness (alarms etc) meant HCL was allowed.

I turn the alarms off at night now HCL keeps everything in track without intervention.
 
Richard F said:
Careful with exaggerating hypo unawareness, it'll effect your driving license. My management was good, but the stress and sleeplessness (alarms etc) meant HCL was allowed.

I turn the alarms off at night now HCL keeps everything in track without intervention.
Click to expand...

There is a difference between being non hypo aware…. And HAVING hypos and not being aware

The former will not affect a regular driving license, the latter ‘may’.. ie you can have hypos just not ones that need assistance of others.. so you may have serious hypos so long as you self treat without help

For vocational licenses like HGV you MUST be hypo aware

So with a normal car license you can claim to be totally unaware of hypos, however you MUST NOT claim to have had hypos either whilst* driving, or that have needed help of others

*whilst driving you are Required to do adequate blood tests, so a hypo whilst driving and you can actually be charged with driving under the influence
 
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