Process for switching to pump therapy.

[VespaMB]

HI
I am new to this forum but have been an Insulin dependant Diabetic for 35 years.

Control has never been perfect but the last few years have been worse due to seperation from wife and loss of father and brother , self control and health have been low on the agenda.

I have just had to have laser on both eyes as a result and now need to get a grip on my Diabetes before its to late.

I need to take quite high doses of insulin to try and keep sugars down but seem to have become somewhat insulin intolerant ie its taking more and more to keep stable although still high. ( HBA1C usualy above 10 / 11 )

Ive been refered back to my Hospital clinic by GP as I missed the last few appointments but I know he is no fan of the pump .

Do you think the pump would help me gain better control and how can I persuade a consultant who thinks they offer no better results than frequent injections ?

Any advise appreciated

Cheers

Mark

 

[novorapidboi26]

Firstly its good to get educated on how to adjust your insulin for your food/illness/exercise............

have you had this education?

everywhere is different even though the pump qualifying criteria is the same..............

I had to give evidence that despite a more than good effort with a basal/bolus regime and armed to the teeth with dose adjustment knowledge and tactics, I still could not achieve an HbA1c of below 8%.....

I also suffered from the Dawn Phenomenon...

And also was starting to get more frequent changes in my eyes......

The pump could help you, but its really wise to get to grips with the insulin's out there and there differences as well as a good knowledge of what your personal insulin needs are.....

what is a typical daily dose for you?

what insulin regime are you on?

how much do you weigh/are you overweight?

how many carbs would you take in a day.......?

 

[VespaMB]

Firstly its good to get educated on how to adjust your insulin for your food/illness/exercise............

have you had this education?

everywhere is different even though the pump qualifying criteria is the same..............

I had to give evidence that despite a more than good effort with a basal/bolus regime and armed to the teeth with dose adjustment knowledge and tactics, I still could not achieve an HbA1c of below 8%.....

I also suffered from the Dawn Phenomenon...

And also was starting to get more frequent changes in my eyes......

The pump could help you, but its really wise to get to grips with the insulin's out there and there differences as well as a good knowledge of what your personal insulin needs are.....

what is a typical daily dose for you?

what insulin regime are you on?

how much do you weigh/are you overweight?

how many carbs would you take in a day.......?

Hi
Thanks for above.

I am pretty well educated on Diet and Insulin after 35 years but that doesnt mean i'm always good !

I changed Insulin about a year and half ago and requirement went right down for a while but number of units has gradualy increased.

I have 20 units long acting in the Morning & 20 at night . Novorapid 3 x a day with meals , amount depends on carb intake but usualy between 12 & 22 each meal . Excersise is patchy due to lifestyle and work. Usual Carb intake about 150 a day

Was hoping that pump would give me more control and avoid additional jabs when sugar levels spike.

Another issue could be the lumps that have formed under skin in recent years , this plays havoc with the insulin absorption depending on where you inject , you might get a good spot and bingo , other times a fatty area and virtualy no effect. ( 35 years of injections takes its toll )

The joys of diabetes.

 

[Spiker]

Your GP is right about the clinical data on pumps. Statistics for pumps show no improvement in Hba1c. But they show that the same Hba1c can be achieved with fewer hypos and better quality of life. Those are the stats (as told to me this year by my pump team when I asked for the NHS evidence base). However individuals are not statistics and motivated individuals can do better with a pump because of the much greater control of insulin delivery fine tuning that it provides.

Two interventions that are likely to have a better effect on your Hba1c are the DAFNE course and a low carb diet. There is strong evidence for both.

 

[novorapidboi26]

your not on that much insulin, in fact I was on more before the pump...........

I was on 38 units of Levemir overnight and 32 in the morning, which is 70 in total.........

I was on a 3:1 ratio for breakfast and usually had about 25 g of carbs, so 7.8 units.....

The rest of the day was 2:1 and I had about 200 g overall, so about 40 units.....

so in total I was putting in about 118 units a day..........

on the pump I now take between 50 and 70, sometimes more at weekend, so practically halved.........I dropped a stone in weight without even noticing.............less insulin is better for us all as bigger doses are unpredictable and hard to manage.....

your 150 g of carbs a day should be very manageable and give you good blood sugars........

when your blood sugars spike, unless they are uncomfortably high, you shouldn't be correcting, as essentially it will come back down again after 4-5 hours.....when are you spiking........? and what is the spike like in relation to your pre meal BG....?

a good way of tackling spikes is to get the insulin in well before you actually eat........you can experiment with the timing, ideally 10 minutes before you eat, but it can go more than that, I ended up on about 30 minutes across the day but have been at 45 minutes............you should play about with the timing and see what works for you......

your lumps could be a problem and the pump could help with that if your team conclude there are significant issues............

has your rotation of injection sites been sufficient do you think...........?

a pump would help but i believe there are few more tricks you could try before taking the plunge.........

have you attended DAFNE or something similar.....?