Help! What's wrong with me?

[SandyDee]

I'm not sure if anyone else has had this issue, although according to a Newcastle University study most diabetics lose their warning signs after a few years. I have had no hypo warning signs for a long time now. It took a long time and 3 hospitals to even work out why I kept passing out, but eventually a consultant with enough brain cells to start a fire worked it out and raised my overall sugar levels to try and get them back. Unfortunately I never have, 5 years ago I got the pump in the hope this would help, but no joy. I've now had diabetes for 28 years and have noticed in the last 3 years a decline in the diabetes generally, I have always had the amazing ability to function with very low blood sugars, but now I not only have no warning signs but they change very quickly, e.g. last Thursday I was out at a meeting, because anything different causes me to go low I always do a temp basal and lower it by 40 - 50%. Before leaving the meeting I checked my BM as I would be walking for about 10-15 mins. It was 8.9 so I left it. 30 mins later it was 1.9! I have been off work with depression because of this problem, I have stoppped going out unless I absolutely have to, I am terrified and embarrassed about going hypo and I don't know what to do.
I was seeing the diabetic consultant and nurses a lot when I first went off work and my consultant was going to try and get me approved as a special case for CGMS, but when my HBA1C improved (partly because I stopped doing anything) they said they could no longer make a case for it. I'm at my wits end, any advice?

 

[noblehead]

Sorry about all the problems you are experiencing. I'm not a pump user or had any experience of getting a CGM, but a book that often gets mentioned on this forum and the DOC is Pumping Insulin by John Walsh & Ruth Roberts, might be worth purchasing to see if this helps with your diabetes control.

 

[Flowerpot]

Hi SandyDee

CGM funding is considered on an individual basis as there are no specific NICE criteria for its use. As far I am aware the main reason for requesting funding is loss of hypo awareness resulting in serious hypos affecting your life. HbA1c is one of the criteria for pump funding and I would hope a low HbA1c wouldn't rule you out of putting in a request for CGM funding. Presumably your HbA1c has also dropped because of the number of very low readings you are getting.

If my memory serves me I think my HbA1c was about 7.5% before I started using CGM, my last one on CGM was 6.2% (this was deemed too low by my consultant in someone with no hypo awareness) My HbA1c wasn't mentioned as a reason to prevent a request for funding, the primary concern was serious hypos with no warnings.

I would ask your diabetes consultant on what grounds he/she considers a reduction in HbA1c rules you out of requesting funding for CGM when there are no specific NICE criteria for its use and ask what you can do for them to support an application for funding. Even with support getting funding approval may not be straightforward.In the mean time can your clinic loan you a CGM for a week to try and see when you are dropping so rapidly?

Best Wishes.

 

[SandyDee]

I had 3 weeks on CGMS which was great because it alarmed when I was heading low and gave me a chance to respond whereas normally I am away with the fairies before I know something is wrong. The problem is because I have stopped doing anything I dont have many hypos now, but if I am to return to 'normal' life I know they will start again. My consultant said there is no adult funding for CGMS and so would have to make a special request for it which was easy when I was working and having regular hypos but now I'm not having enough hypos to make a case. He doesn't seem to understand and I know I didn't explain very well that it will all start again when I go back to work. Work is very stressful and stress sends me low, but also just a 5 minute walk sends me low probably because I am constantly stressing out thinking I am going to go low.