Hi Joenya.
There is lots of information available in a variety of places, but to get you started I'll outline a few key points:
Pumps
1) A pump is not an automated solution: it requires you to do carb counting and blood tests, perhaps like you do at the moment. If you don't currently carb count or do more than 2-3 BT a day, you should start learning to do that if you're thinking about a pump.
2) There are several major benefits to having a pump:
- Smaller doses, therefore better accuracy e.g. most pumps do at least a 0.05 unit increment
- Adjustable background level. Unlike Lantus or Levemir, a pump just uses short-term Insulin (like Novorapid or Actrapid) and gives it all the time (or every 3 mins) to act more similarly to a fully functioning pancreas. This means if you are more sensitive to insulin, say in the early hours, you can reduce your pump's output at the time automatically, unlike if you had given Lantus where you have no options to 'reduce' it in the morning.
- Intelligent bolus doses. You can give a bolus all at once, in stages, or spread over a time period.
- Carb Wizards are built into most meters to help you calculate your Insulin based on your BT result, carb intake, and adjustable ratios according to the time of day.
3)
Google these for several of the main pumps available in the UK:
- Animas 2020, Animas Vibe
- Medtronics Paradigm Veo
- Roche Accu-Chek Combo
- Dana Diabecare R
There are more, but these are the ones I have seen most about because many PCT (primary care trusts) offer them. They all offer broadly similar functions, but some of the differences are:
- Real waterproofing. They're all splash proof, but if you go swimming, Animas claim their's is best.
- Remote control. Don't want to have to scrabble around inside a coat and three jumpers to find your pump? Several offer a remote, some remotes are built into the BT device so you have less bits to carry around too.
- Useability/Interface. Trying the pumps out in real life is very helpful, as the screens, buttons, layout and software can help you decide which one you'll get on with day-to-day.
4) CGM - Continuos Glucose Monitoring
This is available in combination with some pumps, but not others. Some people have found it really useful, some not so much. This is much less widely available on the NHS.
Getting Started
1) NICE (The National Institute for Clinical Excellence) says that if you fit the 'criteria', you should be given a pump. No waiting lists, no 'we have given out all the pumps we can afford this year'. If you fit the criteria and they won't give you one, you have a big right to do something about it.
The criteria are (from memory) EITHER: unable to reach an HbA1c of 8.5 or lower without many hypos, OR experiencing frequent hypos OR severe disabling hypos.
In experience, some Drs are very different on their approach. I had one consultant who said it would only make a difference of 0.5% to my HbA1c so he wouldn't do it without me getting my control better first (like I wasn't already trying....!) Whereas I moved and the consultant actually
suggested a pump at my first visit!!
Some of the info is here:
http://www.nice.org.uk/TA151
Also see here:
viewtopic.php?f=19&t=17654
2) The best step to get started is to ask your care team about it. Say you have read up on it, think it would benefit you, and why. They should be able to talk to you about it and offer a lot of information, possibly leaflets about pumping and about specific pumps. They might have a specialist diabetic nurse who knows about pumps, or a consultant who has an interest in pumps. Try and find out (maybe from other diabetics, or from a friendly receptionist/nurse) who to talk to.
If they fob you off, say that you'd like a separate appointment with the consultant/diabetic specialist nurse to talk specifically about pumps. Then they have a chance to look into it, and you can do some more research and prove to them you're serious about it by getting your carb counting right on track.
3) Come back here and report your progress! There are plenty of people who've experienced most situations in this journey and can offer wise words
Good luck!
