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Type 1 Diabetes
Is an insulin pump just another insulin delivery device?
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<blockquote data-quote="tim2000s" data-source="post: 2081601" data-attributes="member: 30007"><p>[USER=181361]@helensaramay[/USER] - I see this response over and over, and I think it's endemic amongst health professionals.</p><p></p><p>Leaving cost aside, the issue is that it is a retrospective view of living with insulin based on "How it's always been done".</p><p></p><p>The key at diagnosis is to help someone lower their glucose levels and maintain those levels safely. If you put someone on a pump immediately at diagnosis, teach them about the small amounts of insulin it can deliver and how to use it, and provide a positive overview of the benefits of doing so, it's rather different to the model we have of learning about different types of insulin, etc. Psychologically then, if it's what you are taught from diagnosis, then why should it be additionally onerous? It's the same argument that's given about CGM or Flash from diagnosis.</p><p></p><p>I personally don't understand, when people need really small doses of insulin, and more adjustability due to remaining insulin production, why pumps don't make sense at first, and the limited studies of immediate use of CSII seem to show good outcomes, although with small cohorts, e.g. <a href="https://www.ncbi.nlm.nih.gov/pubmed/17109598" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/17109598</a>.</p><p></p><p>It sits squarely in the same view as "You only deserve a pump because there's something you can't manage easily on MDI", which much of the NHS pump provision works from. I get that those with long term use of injections may be adverse to using pumps for various reasons (including attachment to a device), but I do think that we don't help ourselves in how we talk about and discuss these different types of insulin delivery and approaches to living with type 1 when people are first diagnosed.</p></blockquote><p></p>
[QUOTE="tim2000s, post: 2081601, member: 30007"] [USER=181361]@helensaramay[/USER] - I see this response over and over, and I think it's endemic amongst health professionals. Leaving cost aside, the issue is that it is a retrospective view of living with insulin based on "How it's always been done". The key at diagnosis is to help someone lower their glucose levels and maintain those levels safely. If you put someone on a pump immediately at diagnosis, teach them about the small amounts of insulin it can deliver and how to use it, and provide a positive overview of the benefits of doing so, it's rather different to the model we have of learning about different types of insulin, etc. Psychologically then, if it's what you are taught from diagnosis, then why should it be additionally onerous? It's the same argument that's given about CGM or Flash from diagnosis. I personally don't understand, when people need really small doses of insulin, and more adjustability due to remaining insulin production, why pumps don't make sense at first, and the limited studies of immediate use of CSII seem to show good outcomes, although with small cohorts, e.g. [URL]https://www.ncbi.nlm.nih.gov/pubmed/17109598[/URL]. It sits squarely in the same view as "You only deserve a pump because there's something you can't manage easily on MDI", which much of the NHS pump provision works from. I get that those with long term use of injections may be adverse to using pumps for various reasons (including attachment to a device), but I do think that we don't help ourselves in how we talk about and discuss these different types of insulin delivery and approaches to living with type 1 when people are first diagnosed. [/QUOTE]
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