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Newly diagnosed, thinking about pump
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<blockquote data-quote="Capt-Slog" data-source="post: 2267116" data-attributes="member: 500850"><p>Hi Matey,</p><p></p><p>Firstly, and most importantly, well done for taking the time to do some research and asking some excellent questions.</p><p>I will try to answer your questions based upon my own experience, but bear in mind that each person can have a different experience.</p><p></p><p>Q1. Lipodystrophy.</p><p>You may, or may not have to keep in your cannula in for 3 days. A few things can affect this. I was started on a Teflon canulla which I was told would last 3 days. However, my experience was that the Teflon was not injecting the insulin deep enough and I was suffering from a large number of the Teflon canulla were bending instead of going in. </p><p>Therefore I decided to change to Steel canulla. These did not bend (Pro). They were a little longer (Pro). They did not need a big insertion tool (Pro). </p><p>However... (there is always a BUT)... the steel cannulas have to be changed every two days. </p><p></p><p>The other thing that will affect how often you change your site is how much insulin you will need to take. </p><p></p><p> If you currently take a LOT of INSULIN, as I do, then you have to evaluate how much insulin your pump can hold. My insulin intake was so high, that I had to have a pump that could contain more than 200 units as I need about 250u every two days. </p><p></p><p>"How do I know how much insulin I will need?" </p><p>When I did my pump course, they used a special form that I had to fill in and the first calculation was how much insulin I would need. </p><p>To work this out, you have to add together both of the insulins you inject using your pens and then take away about 30 percent. </p><p></p><p>So, if you take 75u of Basal insulin and about 75u of Bolus throughout the day, then you add them together (150u) then times by 0.7. So 150u x 0.7 = 105u</p><p>So this is your daily requirement.</p><p></p><p>So, if you did need this much insulin (like I did) then 2 days = 210u and 3 days would be 315u.</p><p></p><p>Most pumps only hold 200u.</p><p>However, MOST diabetics take much less insulin a day than me.</p><p></p><p>Lipodystrophy can be an issue if you put the canulla in the same place every time.</p><p></p><p>2). Sleeping with a cannula.</p><p>I have never had an issue with bleeding cannulas at night time.</p><p></p><p>3) Pump availability</p><p>You will be lucky if you have a choice to be honest. Lots of people report that their team only offer 1 or 2 pumps.</p><p>I was lucky, because my team offered a choice of 5 pumps, which is very rare.</p><p>However, I wanted a pump that they did not offer, and by proving that I had done ALL the research, and I presented my Endo with a fully listed set of reasons why I wanted a specific pump, they supported my case to get my pump added to the list.</p><p></p><p>To be honest, the thing that will probably affect your decision will be whether you will want a tubed pump or a patch pump.</p><p>In my group of pumpers, I was the only one who asked for a tubed pump. The other 9 people all asked for a patch pump.</p><p></p><p>By "self-adjusting" I take it that you mean pumps that have software that has a closed loop system. There are not many pumps that currently do this. The issue that you come up against here is not getting the pump, it will be getting the right CGM. Quite a few diabetics have got Freestyle Libre sensors via the NHS but these on their own are not true CGM devices. Libre are actually FGM sensors and therefore you will either have to buy a device called a MiaoMiao (£160), or try to convince your Endo to support you to have a Dexcom G6 sensor.</p><p>GOOD LUCK ON THIS. Very few adults are given Dexcom sensors on the NHS.</p><p>To self-fund a G6 costs £159 a month.</p><p></p><p>4) Pump failure</p><p>This appears to be a very rare event in the Diabetes world. I am not saying it doesn't happen, just that it doesn't appear to happen very often.</p><p>Incorrect dosing is almost ALWAYS the fault of the user, not the pump.</p><p>With every new pump, there comes a period of learning, whilst you get used to using it. Also, getting the right type of cannula can affect how well your pump works.</p><p></p><p>5) Travel.</p><p>Here I no personal experience as I have not been on holiday since getting my pump.</p><p>I blame HMRC for this for mucking up my tax code them "stealing" all my money!</p><p></p><p>I know this is a big reply. But you asked a lot of questions.</p><p></p><p>Good luck</p><p></p><p>My pump: Tandem t:slim X2</p><p>My CGM: Freestyle Libre + MiaoMiao</p><p>Cannula: 6mm Trusteel with 13" tube</p></blockquote><p></p>
[QUOTE="Capt-Slog, post: 2267116, member: 500850"] Hi Matey, Firstly, and most importantly, well done for taking the time to do some research and asking some excellent questions. I will try to answer your questions based upon my own experience, but bear in mind that each person can have a different experience. Q1. Lipodystrophy. You may, or may not have to keep in your cannula in for 3 days. A few things can affect this. I was started on a Teflon canulla which I was told would last 3 days. However, my experience was that the Teflon was not injecting the insulin deep enough and I was suffering from a large number of the Teflon canulla were bending instead of going in. Therefore I decided to change to Steel canulla. These did not bend (Pro). They were a little longer (Pro). They did not need a big insertion tool (Pro). However... (there is always a BUT)... the steel cannulas have to be changed every two days. The other thing that will affect how often you change your site is how much insulin you will need to take. If you currently take a LOT of INSULIN, as I do, then you have to evaluate how much insulin your pump can hold. My insulin intake was so high, that I had to have a pump that could contain more than 200 units as I need about 250u every two days. "How do I know how much insulin I will need?" When I did my pump course, they used a special form that I had to fill in and the first calculation was how much insulin I would need. To work this out, you have to add together both of the insulins you inject using your pens and then take away about 30 percent. So, if you take 75u of Basal insulin and about 75u of Bolus throughout the day, then you add them together (150u) then times by 0.7. So 150u x 0.7 = 105u So this is your daily requirement. So, if you did need this much insulin (like I did) then 2 days = 210u and 3 days would be 315u. Most pumps only hold 200u. However, MOST diabetics take much less insulin a day than me. Lipodystrophy can be an issue if you put the canulla in the same place every time. 2). Sleeping with a cannula. I have never had an issue with bleeding cannulas at night time. 3) Pump availability You will be lucky if you have a choice to be honest. Lots of people report that their team only offer 1 or 2 pumps. I was lucky, because my team offered a choice of 5 pumps, which is very rare. However, I wanted a pump that they did not offer, and by proving that I had done ALL the research, and I presented my Endo with a fully listed set of reasons why I wanted a specific pump, they supported my case to get my pump added to the list. To be honest, the thing that will probably affect your decision will be whether you will want a tubed pump or a patch pump. In my group of pumpers, I was the only one who asked for a tubed pump. The other 9 people all asked for a patch pump. By "self-adjusting" I take it that you mean pumps that have software that has a closed loop system. There are not many pumps that currently do this. The issue that you come up against here is not getting the pump, it will be getting the right CGM. Quite a few diabetics have got Freestyle Libre sensors via the NHS but these on their own are not true CGM devices. Libre are actually FGM sensors and therefore you will either have to buy a device called a MiaoMiao (£160), or try to convince your Endo to support you to have a Dexcom G6 sensor. GOOD LUCK ON THIS. Very few adults are given Dexcom sensors on the NHS. To self-fund a G6 costs £159 a month. 4) Pump failure This appears to be a very rare event in the Diabetes world. I am not saying it doesn't happen, just that it doesn't appear to happen very often. Incorrect dosing is almost ALWAYS the fault of the user, not the pump. With every new pump, there comes a period of learning, whilst you get used to using it. Also, getting the right type of cannula can affect how well your pump works. 5) Travel. Here I no personal experience as I have not been on holiday since getting my pump. I blame HMRC for this for mucking up my tax code them "stealing" all my money! I know this is a big reply. But you asked a lot of questions. Good luck My pump: Tandem t:slim X2 My CGM: Freestyle Libre + MiaoMiao Cannula: 6mm Trusteel with 13" tube [/QUOTE]
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