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NHS artificial pancreas roll out.

Zinadane said:
So I wont be offered one as my hba1c is not above 58mmol?
300,000 type 1s in the UK.
I wonder what number/percentage of people with type 1 will be catered for with the 58mmol threshold criteria?
I'm some way of 58, but I guess if your hovering between 50-55 then this is an incentive for you to worsen your control and qualify for an artificial pancreas!
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I think I would refuse if offered. The idea of having some kind of "machine" stuck to me just doesn't appeal . . I find the libre 2 sensors annoying enough.

How big are these "artificial pancreas" things anyway? I have visions, and the visons do not look good.
 
TheRightStuff said:
I think I would refuse if offered. The idea of having some kind of "machine" stuck to me just doesn't appeal . . I find the libre 2 sensors annoying enough.

How big are these "artificial pancreas" things anyway? I have visions, and the visons do not look good.
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This is the sort of set up (with the libre 3) my colleague’s 3/4 year old has.
The kid’s been on it for about a year now…? https://www.ypsomed.com/en/diabetes-care-mylife.html

I’m not actually a fan of the term, “artificial pancreas.”
I heard this term for a pump 4 decades ago on the science program Tomorrows world? I feel if it was doing the job of a real pancreas, it would be installed into the body & a more autonomous in it’s reaction & function regarding diet & hormonal changes…

I feel we’re a long way off “that..”
 
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Same, would want it. Well not yet anyway.
People do and it works for them.
I certainly don't like the idea of having a mechanical pump driven by software algorithms coming from a cgm which is not always accurate pumping insulin into me.
One day maybe and of course it is a step in the right direction.
 
Zinadane said:
Same, would want it. Well not yet anyway.
People do and it works for them.
I certainly don't like the idea of having a mechanical pump driven by software algorithms coming from a cgm which is not always accurate pumping insulin into me.
One day maybe and of course it is a step in the right direction.
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From what I gather.

If the CGM senses a drop in BG level representation in interstitial fluid, it stops the basal..
now I find for me the Libre pretty accurate.
What spooks me? Is the programmed algorithm cutting a set basal rate whilst there actually could be an active bolus causing the low…?
So I treat the hypo. I know how to treat this on MDI.
My colleague did have an issue with his son where the device cut off & his kid wound up in the 20s. I couldn’t help him (regarding the CLS pump. (I don’t pump.) & neither could the DSNs assigned to his kid?

At least on his behalf. There seems to be a lack of HCP training? From the feedback I get..
They are “blagging” it…
 
I’ve been thinking a bit more about pumps recently.
My main issue with mdi regime are those odd bad days of unexplained highs which need a lot of corrective doses to get on top of!
After some research I got myself a dummy 'medtrum nano' patch and read into the aaps android jargon.
The pump seems pretty small (the smallest I believe) and discreet. I started thinking I could probably live with this thing and started dreaming about much easier days living with diabetes.
So, I contacted my DSN.
They have offered me a pump assessment. Apparently, there is a waiting list though as a lot more requests now following a change in funding/guidelines.
Unfortunately, though the medtrum is not available following a DTN statement about its potential safety/efficacy.
I’m starting to feel less scared of the technology, I’m sure one day I will get one.
But it has to be small and discreet and not something which I will always be aware of wearing.
 
I read earlier in the post that the criteria for a pump on the NHS is that you have to have Hb1ac of over 58 to qualify , that seems quite high and I was just wondering how many of us type 1s on the forum would be eligible for one ?
 
jaywak said:
I read earlier in the post that the criteria for a pump on the NHS is that you have to have Hb1ac of over 58 to qualify , that seems quite high and I was just wondering how many of us type 1s on the forum would be eligible for one ?
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You can have other reasons instead of that though, my HbA1c was lower than that when I got mine, I got it due to problems with my overnight blood sugars not staying anywhere near flat (dawn phenomenon related stupid highs most of the time (starting at 3am), or very low from about 2am all night)
 
jaywak said:
I read earlier in the post that the criteria for a pump on the NHS is that you have to have Hb1ac of over 58 to qualify , that seems quite high and I was just wondering how many of us type 1s on the forum would be eligible for one ?
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I think it’s more a case of 58hba1c being suggested as a cost effective cut off at which to offer hcl pump systems.
From what I’m hearing though you can make a claim based on mdi regime causing you hyper or hypo difficult situations. Basically go and blag a poor quality of life story and demand one I think!
 
Zinadane said:
I think it’s more a case of 58hba1c being suggested as a cost effective cut off at which to offer hcl pump systems.
From what I’m hearing though you can make a claim based on mdi regime causing you hyper or hypo difficult situations. Basically go and blag a poor quality of life story and demand one I think!
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Tried that with my endo but he was shaking his head so often during my story I thought he’d developed a palsy.
 
jaywak said:
I read earlier in the post that the criteria for a pump on the NHS is that you have to have Hb1ac of over 58 to qualify , that seems quite high and I was just wondering how many of us type 1s on the forum would be eligible for one ?
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you spend more of your time taking more and more daily injections to keep your bg in range, but then you don't qualify...Madness!
 
Zinadane said:
yep 8-10ish most days if on a high can be up to 15ish I guess, I'm skinny and only use abdomen which can become a battle ground!
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I would say I'm skinny 12 st and 5 ft 10 tall and yes I sometimes have to inject 10 - 20 times a day but due to the fact I have fat pockets around my abdomen caused by many years of using them big needles like nails and firing them in with a device like a vet would use on a bull I am restricted to arms and legs but would still say with the modern needles it's still not really a problem , perhaps we just get tougher with age .
 
jaywak said:
sometimes have to inject 10 - 20 times a day
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Is this using some sort of rapid insulin? If not how do you avoid stacking or is that something you learn how to handle.

I've taken quite a few correction doses, but always made sure they were at least two or three hours prior to my next meal/injection. There are many times I could have done with more.
 
Only 1 Basel injection and then a couple of fast acting Bolus units as and when required , stacking doesn't seem to cause a problem for me but I think it could for some people , we are all different after all .
 
jaywak said:
Only 1 Basel injection and then a couple of fast acting Bolus units as and when required , stacking doesn't seem to cause a problem for me but I think it could for some people , we are all different after all .
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I think there are a few different systems. My understanding of the hcl system, is one reservoir for one bolus insulin, which is then micro dosed to mimic basel effect with further doses given for balancing carbs. All tailored to suit via personalised app/algorithm.
Otherwise known as an artificial pancreas AAPS. I think anyway
 
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