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Getting a pump!!

Pudgem

Member
Messages
11
Type of diabetes
Type 1
Treatment type
Insulin
Hi everyone.

This is my first post, although I have been reading the forum for some time now.

I found out today that I have been approved for a pump which I am so please about. I was diagnosed at 13 yr old in 1999 and was on twice daily injections until feb last year when I got a place on dafne. I found it amazing and learnt more in that week than I had since diagnosis.

My hba1c came right down after the dafne course to around 48 which was probably the lowest it had ever been. The only problem was that I was having 3 or 4 hypos a day.

Since then I have not been quite as well controlled, partly from snacking more and secondly from just being fed up of all the hypos getting in the way of life and work. I also have had the dawn phenomenon since changing to mdi which I cannot sort no matter what I try.

Today as well as finding out about the pump, I got my latest hba1c which is now 65. I am quite upset about it as I am putting so much in but not getting the results I want.

Has anybody else been in this position, and found the pump to help? I know it will take work to make adjustments but I am willing if I can get it right.

Now I just need to decide what pump - the insight or the 640g....

Thanks for listening


Mark
 
Congrats on being given the pump go ahead Mark!

The pump should be a good help with sorting the high sugars first thing in the morning.

Ed
 
Hi Mark this is basically identical to my story I was having 5-6 hypos a day and really struggling wasn't getting an accurate HBA1C because of the hypos. Anyway was put on a pump in August and has changed my life its the best thing to ever happen to my diabetes, my control is so tight everything has improved dramatically, I have my life back. Its lots of hard work but so worth it.
 
Thanks for your replies guys. I was on such a high this morning when I found out about the pump, and then plummeted to a humongous downer when the doctors phoned about my hba1c results.

Can I ask for those on a pump - do you all low carb, or do some still eat normally (I say normally as in not particularly worrying about diet as such)? Do you snack and eat chocolate when you feel like it and just bolus for these?

I think maybe part of my problem is that I need to go back to writing diaries and looking at each day at what is happening - it's just a bit of a ball ache and hard with my job which sees me in and out of the office, at meetings and appointment etc.

For those pumpers also using cgm - how much of a benefit has this been, and would you say it is just as good as a stand alone system as it is integrated into a pump (640g)?

Thanks again!
 
Don't worry your results will come down again. I eat very little carbs but that't because I need to lose some weight. I do find eating little carbs under 20g a day keeps my bloods really neat. You can eat normally though and bolus for whatever you eat.
 
Great news about the pump Mark, I do hope it helps resolve some of the problems you are experiencing now.

As for snacking between meals, much like on MDI you will have to be mindful of IOB and your pump will take this into consideration when working out your meal-time bolus doses, I don't snack myself but on a pump it is possible and I'm sure many pumpers do so.

I don't low-carb but don't eat high-carb either - choosing to eat carbs in moderation, but overall a pump is an excellent insulin regime as you can fine tune your basal rates, deal with things like DP and reduce nocturnal hypo's , I've had far fewer hypo's since switching to a pump then I did on MDI which many find to be the case, being able to give small increments of insulin on a pump does make a big difference to bg control as I'm sure you will find out soon yourself.
 
Hey Mark!

I got a pump last year and it's changed my life! It does take some adjusting but it's so worth it!! Like you I got terrible DP - that doesn't exist at all for me now with the pump!

Can't help you with your pump options as I don't have either of them, or with cgm as I've not had one.

Regarding eating I eat really low carb sometimes and fairly low carb other times - A lot less carbs than what I used to eat! just find it much easier with spikes n things.

Did they say how long you will have to wait now you've been approved?
My A1c is similar to yours but the other way round, was 66 before I got my pump, a year later it's 48!

Abbie xx
 
Hi Mark

Using a pump will give you so much flexibility and fine tuning to cope with specific problems such as DP. I find my hypos on a pump are less severe and less long lasting. The ability to set various basal profiles for different days etc is invaluable so is being able to set temporary basal rates either increased or decreased to cope with exercise,unplanned events or illness.

Going back to basics and keeping a diary of food , boluses etc really helps to see what happens when and why. It will be good training for all the testing and adjusting you need to get the settings right on your pump.

I use CGM due to loss of hypo awareness and mine is integrated so gives me a Low Suspend feature that cuts off insulin to my pump if I go below a preset glucose limit. CGM whether stand alone or integrated offers amazing insight into what goes on between finger blood tests and provides a wealth of information to help see patterns, fine tune basal rates etc. Most diabetes clinics can loan a CGM for a week so ask your team to see if it is something you could try out.

I'm waiting to start the 640g but not for the next few weeks as it has only recently been released and there aren't many people using it as yet.
 
Thanks for your replies everyone!! Am feeling better knowing the others have improved hba1c so much and so quick after moving to a pump. I am under no illusion that it will magically solve all of my problems, but hope that the flexibility it offers will be worth the time and effort i will be putting in!

I do need to get back into the habit of recording a diary. My biggest issue with it has been the extra time it takes on top of the bg test, counting carbs and injections. i guess i get fed up of only starting to eat when everybody else has almost finished! haha! I have tried both the dafne app for recording everything and the old school hand written book but both take just as long to be honest so i just need to get in the habit.

I am just waiting for an appointment to discuss my choices for the pump. i am leaning towards the new 640g i think. I really liked the look of the insight when that was launched, but now i think the option of integrated cgm, and the fact you don't always have to have the provided bg meter to use the bolus wizard has changed my mind (i.e. you can input the bg reading manually after using a separate bg meter). My nurse did say that because they bulk ordered the veo, they would need to use these up before i'd be able to get a 640g, so i guess if i do choose that one then there may be a wait.

Flowerpot - with the cgm, do you self fund, and if so do you use it all the time, or only when required? It is going to be a big commitment to self fund continuously at £200 a month!!

Can i ask with the low carbing - how easy do you guys find this? I constantly feel the need to eat carbs out of habit, and struggle to think of what to have with meals etc. Do you just have an extra serving of veg with meals, or just drop it completely?

I can see me asking a lot more questions, especially once the pump comes along, so hope you don't all mind!

Mark
 
Hi Mark,
I'm awaiting the new pump with intergrated CGM. I'm getting the CGM funded for me because I don't have hypo awareness. I think the funding would depend on your case. If you wanted it but didn't exactly have something like loss of hypo awareness you'd have to fund it yourself. Hope this helps in your decision.
 
You usually get given 1 or 2 Contour Link meters with a Medtronic pump that send the results directly to your pump. You can use whichever meter you wish if you want to stick with what you're used to and input the bg result manually but I find it much easier and quicker to use the Contour Link.

I don't self fund CGM, I haven't got hypo awareness and was going unconscious where and whenever and had some close calls. If you decide to self fund there is another option where you can extend the sensor life and reduce the running cost a little. If you choose the Medtronic 640g only Enlite sensors are integrated with that pump to enable basal suspend etc and the maximum sensor length I have managed to get is 7 days.

Good luck choosing a make of pump and getting started, my clinic only dealt with Medtronic so no decision for me.
 
Thanks Flowerpot - I miss-read your original post that the Nhs had funded for you. I guess part of the decision I need to make also is whether it is would having the complete system with the new smart guard, or going with either the Medtronic or insight pump and funding the dexcom where some have extended the sensors hugely (I have read a few lasting 60 days which seems crazy) dexcom overall seems like it could work out cheaper.

Haha I think sometimes I'm my own worst enemy when researching. I end up thinking about too many things!!
 
Hi it's almost 3 years I use a pump and almost 2 years I use a cgm. cgm and pump together have dramatically changed my life (in positive). 2 years my hba1c are excellent and that's mostly thanks to these 2 devices combined. Cgm was funded by NHS for the first 6 months. Now I am self funding. Ask whatever you want or message me if interested in knowing more.
 
Hi Stefano. Thanks for your reply. Could I ask which pump and cgm system you use?

I am definitely interested in self funding cgm whether that be full or part time use, so I guess the things I am trying to decide on are:

Is it worth having an integrated pump, that can act on the info the cgm provides?

Is it beneficial enough to just have that info available so that it can be used to identify exactly what different foods and situation is doing to my bg?

I guess the other factor involved too is the cost - the Medtronic system would be very costly if used full time where as dexcom is likely to be cheaper based on the fact the some are able to make use of the sensors for 14+ days.

I will say that having read about the dexcom G5 which will be able to send data direct to a mobile phone would be great.

So do you use cgm full Time Stefano? (Sorry for all the questions!
)
 
Hi I use medtronic paradigm veo as pump and the enlite sensor as cgm. Main reason is that I had already the medtronic pump so I prefer to have all integrated. I personally find the cgm fantastic as it gives me complete peace of mind. I get alerted if my blood sugar falls below 4.2 or spikes above 10 (these are now my personal thresholds) but I tend to check from time to time after meal, especially if I'm not sure about carbs, and can take action if I see my bag is rapidly spiking, even though it is still within my set range.
I agree CGM are expensive but I don't have routine in my life because of work, lifestyle, gym, meals and I don't low carbs so I found irreplaceable for my needs. Yes each medtronic sensor is supposed to last 6 days and you can extend to 7 days. That's the maximum I ever managed.
Negative side of cgm is that you can feel addicted to it. Without a cgm it is like you are partially blind. With a cgm you see everything which is happening in real time and you can proactively take action. So to answer to your question yes I use a cgm pratically full time. Usually no more than 1 day gap. Just to clarify main reasons for me to use a cgm are my HBA1C results. Ask any question you want, Pudgem
 
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