I am currently in the process of trying to obtain a pump, at first my consultant agreed. I took a carbohydrate counting course, and was told I needed to go on to a cgm to record my blood sugars for five days, which I did. When I went back to see the hospital about my results, they started going on about changing my 24 hour lantus to the morning, instead of the evening when I usually take it? They want me to go back on to the cgm for another five days after this to see if this improves my control. I am feeling a bit worn out by this all now, I don't really want to change what time I take my lantus, and I just want to get on with getting started with the pump. I am also worried they will say I don't need the pump anymore if I get better results this time. I asked if this was the case, and they say I can still go on the pump, but I need to do this first. What I want to know is this normal practice when being considered for a pump, and has anyone achieved better control by changing their 24 insulin? also how long does the process normally take? I really want to be given the chance ,and have a better quality of life, but I am also worried about being let down? Appreciate any advice? :?
Is the pump worth it?
- Thread starter diabeticmumof4
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donnellysdogs
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People that can't listen to other people's opinions.
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Hi Mum of 4....
I think all hospitals, consultants, gp's want to make sure that with the costs of pumps and supplying them etc that they give them to patients that will 1) have tried everything before a pump 2) will accept and use the pump to it's best....using a pump is a totally different regime in a lot of ways to MDI.
Saying all this, I too went from night dose to morning dose to a morning and night time dose of glargine before going to a pump. Depsite changing from the ngiht to morning to both and a hba1c of 7.1 I still had too many lows to uncontrollable high when I got up within an hour, since going to a pump for the first time in 25 years my highs one hour after getting up have stopped, and this is only down to the pump. This result was within 10 days. The only lows I experienced were within the first 3 weeks but thanks to one very special forum member on this website they too have gone.
Medics have guidelines to meet as to the criteria of persons of persons that are given pumps which are set down by NICE. I believe that the guidelines do say about trying all methods of MDI before considering pump therapy.
Answer your question, is the pump worth it? I think so.
I think all hospitals, consultants, gp's want to make sure that with the costs of pumps and supplying them etc that they give them to patients that will 1) have tried everything before a pump 2) will accept and use the pump to it's best....using a pump is a totally different regime in a lot of ways to MDI.
Saying all this, I too went from night dose to morning dose to a morning and night time dose of glargine before going to a pump. Depsite changing from the ngiht to morning to both and a hba1c of 7.1 I still had too many lows to uncontrollable high when I got up within an hour, since going to a pump for the first time in 25 years my highs one hour after getting up have stopped, and this is only down to the pump. This result was within 10 days. The only lows I experienced were within the first 3 weeks but thanks to one very special forum member on this website they too have gone.
Medics have guidelines to meet as to the criteria of persons of persons that are given pumps which are set down by NICE. I believe that the guidelines do say about trying all methods of MDI before considering pump therapy.
Answer your question, is the pump worth it? I think so.
Hello there, thanks for replying, I was a bit confused as to why they wanted me to change my lantus to the morning, as the last time I had seen my consultant she had said I would probably have the pump by November. I had thought I had done what was necessary to meet the criteria for a pump. Although my hbac isn't that bad 6.8, I do suffer from a lot of hypo's, this has affected how I live my life, I don't really go out much on my own for fear of something happening, and they said they had taken this in to account. Obviously from what you have said I might need to try several different regimes before they finally decide on a pump. I'm hoping it will still go ahead eventually, I am glad to hear your pump has made such a difference? I will keep trying, and see where it leads me. Thanks again for your advice?
donnellysdogs
Master
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Mum of 4
Hypo's can be a horrible part of type 1 and shouldn't be affecting your life so badly, so I hope you get your pump without having to go through all the various MDI's. My worst time of hypo's were at nights, and by changing to half dosgae in morning and half dosage in evenings it did completely take away my night hypo's, but not my day ones.
It's a lot to put up with if it is so badly affecting your daily life. My HBA1C was 7.1, which was lower than the 8.5 that the NICE guidelines state, but like you the hypo's affected my life to the point of maybe losing my driving licence. This was when I was put on a pump straight away. Also they couldn't comabat my levels going so high within an hour of getting up, so although my HBA1c was reasonable I was having too many swings in both directions.
I really hope that you can get one. Shame that our care appears to be a postcode lottery still. Our hospital has pumps sat in the nurses office waiting to be dished out, and yet so many other hospitals can put their patients through real turmoil to get one. Some excellent people on this forum to pass on helpful tips...let the hospital diabetic team know just how badly the hypo's affect your daily living-log down every single low and the impact it had and tell them every visit.
Hypo's can be a horrible part of type 1 and shouldn't be affecting your life so badly, so I hope you get your pump without having to go through all the various MDI's. My worst time of hypo's were at nights, and by changing to half dosgae in morning and half dosage in evenings it did completely take away my night hypo's, but not my day ones.
It's a lot to put up with if it is so badly affecting your daily life. My HBA1C was 7.1, which was lower than the 8.5 that the NICE guidelines state, but like you the hypo's affected my life to the point of maybe losing my driving licence. This was when I was put on a pump straight away. Also they couldn't comabat my levels going so high within an hour of getting up, so although my HBA1c was reasonable I was having too many swings in both directions.
I really hope that you can get one. Shame that our care appears to be a postcode lottery still. Our hospital has pumps sat in the nurses office waiting to be dished out, and yet so many other hospitals can put their patients through real turmoil to get one. Some excellent people on this forum to pass on helpful tips...let the hospital diabetic team know just how badly the hypo's affect your daily living-log down every single low and the impact it had and tell them every visit.
Hi Mumof4
When I first asked my gp to refer me to see a pump consultant at my hospital my hba1c was 6.7 which was just slightly higher than my one 6 months earlier being 6.4. At first I thought that I was going to be told that my a1c was too high but I wasn't
. My pump dsn told me that my control was way 'too tight' and that having mild hypos every day wasn't a good way to be and that my fasting bg in the morning needed to be around 7 or 8 before I eat breakfast and then aim to be around 9 or 10 mid morning. By following this my hypos became less and I felt really well with far less anxiety.
The reason why you have been asked to inject Lantus in the morning is because of hypos and when you have them. For you to start on a pump you need ideally to be free of hypos as much as possible and then a more accurate dose of bolus insulin can be established, so bear with your team a bit and allow your bg levels to rise up a bit more.
When I first asked my gp to refer me to see a pump consultant at my hospital my hba1c was 6.7 which was just slightly higher than my one 6 months earlier being 6.4. At first I thought that I was going to be told that my a1c was too high but I wasn't
. My pump dsn told me that my control was way 'too tight' and that having mild hypos every day wasn't a good way to be and that my fasting bg in the morning needed to be around 7 or 8 before I eat breakfast and then aim to be around 9 or 10 mid morning. By following this my hypos became less and I felt really well with far less anxiety. The reason why you have been asked to inject Lantus in the morning is because of hypos and when you have them. For you to start on a pump you need ideally to be free of hypos as much as possible and then a more accurate dose of bolus insulin can be established, so bear with your team a bit and allow your bg levels to rise up a bit more.
jopar
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You clinic are actually doing nothing more than stalling pump thearpy, and by what you are saying some of the methods are in breach of NICE guidelines which is actually ilegal...
The guide lines make no mention of having to attend a carb counting course before pumping, frquently used by PCT as it can stall pump thearpy by 1+ years..
Nor having to been assesed using CGM's, a lot of clinics don't have the kit!
Your lantus change is due to the information gained from the monitoring, by the data it gave it's showing that perhaps that injecting the lantus in the morning will provide better cover over 24 hours!
As to a need to reduce hypo's before starting insulin pumping, well that is one of the biggest bits of missinformation I've heard in a long while, total and utter rubbish...
I would have a word with you DSN concerning your lantus move if you are not happy about doing it, explain how you feel, and if you are going onto a pump in Novemeber as suggested you really could do without the upset that it may bring,,
I would download a copy of the NICE guidelines which basically says if your consultant has agreed that you require pump therapy then the PCT are legally bound to provide funding, and where does it say that since it was agreed that pump therapy was my way forward with control that I had to do this and that.. Aren't you or the pct ilegally stalling????? But do be polite and not throw a wobbley when doing this though... Cool, calm etc comes over so much better..
The guide lines make no mention of having to attend a carb counting course before pumping, frquently used by PCT as it can stall pump thearpy by 1+ years..
Nor having to been assesed using CGM's, a lot of clinics don't have the kit!
Your lantus change is due to the information gained from the monitoring, by the data it gave it's showing that perhaps that injecting the lantus in the morning will provide better cover over 24 hours!
As to a need to reduce hypo's before starting insulin pumping, well that is one of the biggest bits of missinformation I've heard in a long while, total and utter rubbish...
I would have a word with you DSN concerning your lantus move if you are not happy about doing it, explain how you feel, and if you are going onto a pump in Novemeber as suggested you really could do without the upset that it may bring,,
I would download a copy of the NICE guidelines which basically says if your consultant has agreed that you require pump therapy then the PCT are legally bound to provide funding, and where does it say that since it was agreed that pump therapy was my way forward with control that I had to do this and that.. Aren't you or the pct ilegally stalling????? But do be polite and not throw a wobbley when doing this though... Cool, calm etc comes over so much better..
