No pump for me!

Fern Hopper said:

I wonder if there is any incentive for managing my diabetes as well as I have for 57 years?

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I would say so - a healthy body and an ability to continue your life without problems.
That far outweighs having an insulin pump.

Personally I believe there are some funding issues with pumps supply, I am aware locally this is an issue as the NHS has been keen to get more insulin dependent diabetics onto pumps following Partha Kar's advice, however the pot has run dry in some trusts now.

In your shoes I would simply keep pushing as tight control = micro management which can affect your quality of life and is a good strong case for pump therapy, also regardless of circumstances or funding, keep on at your team as those that shout the loudest tend to get heard.

Errr type 1 50 years and 56 fit working hba1c 42 .....haven't seen a dsn or specialist in years....i don't want a pump as i'm quite happy with my way of doing things.

OP has fantastic results and should be congratulated.

Tony

I think this is due to NHS budget constraints. About 10% of the NHS budget is spend on diabetes, but 80% of that money is spent in hospitals for complications. In some hospitals about 1/4 of the beds are for people with diabetes.

The NHS would have more money for things like CGMs and insulin pumps if they didn't have to spend so much on diabetes complications in hospitals.

Fern Hopper said:

I am thinking of trying again for a pump. Do I need to see a consultant for my diabetes care instead of local GP practice nurse?

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From what I can gather it’s the endo that gives the thumbs up..

Also, my endow says the funding is there in my area….
They just don’t have the trained staff? So no pump for me…

I would say the incentive for keeping good control is that you have such a fit and healthy body after 57 years of good control , I have seen so many people fall by the wayside with the I cart be bovered attitude , pat yourself on the back and be thankful you've done so well .

Fern Hopper said:

I am thinking of trying again for a pump. Do I need to see a consultant for my diabetes care instead of local GP practice nurse?

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Yes you need to get approval from your consultant as they hold the purse for pumps, not your GP and your consultant would also arrange the training and consumables supply. Definitely try again, regardless of how good your results are, it requires work and effort to maintain this and a pump would help alleviate some of the work you do, therefore improving your quality of life. However that being said I struggle with long runs on my pump and it requires alot of forward planning prior to starting exercise, so there are swings and roundabouts.

Fern Hopper said:

I am thinking of trying again for a pump. Do I need to see a consultant for my diabetes care instead of local GP practice nurse?

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Definitely specialist endocrinologists and the hospital specialist diabetes nurses are the decision makers - its their budget, not the GP's.

Your GP practice can now prescribe you a Libre 2 or Dexcom One CGM - either an absolute must to have a sufficient track record with to build the justification case for pump need.

If you are already tightly controlled, but have lost hypo awareness and/or suffer recurring nighttime hypos, significant dawn phenomenon rises, etc that you cannot control through MDI, then you may be able to justify moving to a pump.

I'm 5 months into having a pump and can agree with @Juicyj that while it does help, it is definitely not plug, play and ignore - so far it needs almost as much attention as I had needed while on MDI.