GrantGam
Well-Known Member
Morning all!
So had my six monthly review at the clinic yesterday and had an interesting/unexpected discussion with the Dr that ultimately resulted in leaving the clinic with a pump referral
When it came to discussing any issues, the only one I really had was my fairly recent battles with DP. I cite this as the only reason for my raised A1c (40 to 45 in four months). Although still within the "target range", it's a total nightmare and something which means I can't lie in. And when I do (accidentally): hello 12-15mmol/L...
Then came the discussion of my control, as pleased as the specialist was - she asked me how difficult it was to maintain. I replied with a modest response saying that "it wasn't so bad" once having worked out my split basal dosage, DP correction on waking, pre-bolus timings for poorer GI meals, correction factors for exercise/miscalculated mealtime carbs, I:C ratio/basal adjustments for less active days. All in all, between 6-10 injections per day...
Then came the surprise. The specialist asked me if I'd ever thought about pump therapy. I said I had given it good thought due to the flexibility, possible BG control improvements, etc. However, I had never seriously considered it due to not "ticking enough of the boxes". To this she basically said that just because my A1c is not high does not disqualify me from pump eligibility. I did not expect to hear that one bit! She then continued to outline that although my control is perceived as "good", it's coming at a price: multiple daily injections and DP issues. It was reassuring to hear from a Dr that trying hard and succeeding does not make you less eligible than trying and failing, or not trying and failing. It's a relief to hear that you don't have to relax on BG management to let your A1c rise enough to "meet criteria" outlined by a governing body.
To cut a long story short, my visit to the clinic was a good one. What I thought was going to be a 10 minute routine chat turned into an interesting, in-depth talk covering topics from islet cell transplant research to closed-loop artificial pancreas possibilities and pump therapy options! I think the specialist was most pleased with the interest I have in my condition and the firm grounding I have with regards to diabetes and its effects on my body. For the short period of time spent in the Dr's office, the engaging conversation and exchange of information almost made diabetes seem like fun...
Regarding pump funding, hopefully some of the aforementioned will work in my favour. Whether it does or not, I don't know. I'm just pleased that the possibility has been discussed without the need for a battle with those who are there to help. I guess I'm lucky and have a very friendly, kind and understanding care team. Although early days, I'm pretty happy and look forward to seeing how this all turns out.
The concept of a pump does appeal to me very much. I like the idea of having even greater control than MDI, without the need for excessive injections. Adjustable basal rates (or TBR's?) to help my DP would really help me greatly! However, I am concerned about having a "machine" attached to me 24/7. I've never experienced anything like that before so have no idea if it would suit me or not. Potential failures also concern me a bit, I guess without a true basal insulin on-board you're always that bit closer to soaring blood sugars, in the event that there is a delivery problem with the pump's QA insulin.
Even the option to trial a saline pump would be a great opportunity for me. I'd then get a great picture of what life with one would be like. Specifically whether it would be practical for me as a marine electrician. Anyway, we'll just see what happens at my next review in the Spring time
Cheers,
Grant
So had my six monthly review at the clinic yesterday and had an interesting/unexpected discussion with the Dr that ultimately resulted in leaving the clinic with a pump referral

When it came to discussing any issues, the only one I really had was my fairly recent battles with DP. I cite this as the only reason for my raised A1c (40 to 45 in four months). Although still within the "target range", it's a total nightmare and something which means I can't lie in. And when I do (accidentally): hello 12-15mmol/L...
Then came the discussion of my control, as pleased as the specialist was - she asked me how difficult it was to maintain. I replied with a modest response saying that "it wasn't so bad" once having worked out my split basal dosage, DP correction on waking, pre-bolus timings for poorer GI meals, correction factors for exercise/miscalculated mealtime carbs, I:C ratio/basal adjustments for less active days. All in all, between 6-10 injections per day...
Then came the surprise. The specialist asked me if I'd ever thought about pump therapy. I said I had given it good thought due to the flexibility, possible BG control improvements, etc. However, I had never seriously considered it due to not "ticking enough of the boxes". To this she basically said that just because my A1c is not high does not disqualify me from pump eligibility. I did not expect to hear that one bit! She then continued to outline that although my control is perceived as "good", it's coming at a price: multiple daily injections and DP issues. It was reassuring to hear from a Dr that trying hard and succeeding does not make you less eligible than trying and failing, or not trying and failing. It's a relief to hear that you don't have to relax on BG management to let your A1c rise enough to "meet criteria" outlined by a governing body.
To cut a long story short, my visit to the clinic was a good one. What I thought was going to be a 10 minute routine chat turned into an interesting, in-depth talk covering topics from islet cell transplant research to closed-loop artificial pancreas possibilities and pump therapy options! I think the specialist was most pleased with the interest I have in my condition and the firm grounding I have with regards to diabetes and its effects on my body. For the short period of time spent in the Dr's office, the engaging conversation and exchange of information almost made diabetes seem like fun...
Regarding pump funding, hopefully some of the aforementioned will work in my favour. Whether it does or not, I don't know. I'm just pleased that the possibility has been discussed without the need for a battle with those who are there to help. I guess I'm lucky and have a very friendly, kind and understanding care team. Although early days, I'm pretty happy and look forward to seeing how this all turns out.
The concept of a pump does appeal to me very much. I like the idea of having even greater control than MDI, without the need for excessive injections. Adjustable basal rates (or TBR's?) to help my DP would really help me greatly! However, I am concerned about having a "machine" attached to me 24/7. I've never experienced anything like that before so have no idea if it would suit me or not. Potential failures also concern me a bit, I guess without a true basal insulin on-board you're always that bit closer to soaring blood sugars, in the event that there is a delivery problem with the pump's QA insulin.
Even the option to trial a saline pump would be a great opportunity for me. I'd then get a great picture of what life with one would be like. Specifically whether it would be practical for me as a marine electrician. Anyway, we'll just see what happens at my next review in the Spring time

Cheers,
Grant
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