Pump Referral Appointment

helensaramay said:

Thankfully, I did not have to jump this hurdle to get my pump.
However, if I did, I would arm myself with knowledge about the benefits of the pump and why I believe one would help my diabetes control. "I'd rather not inject", "I keep forgetting to take my insulin out with me and it would be good if it was attached", "why can't I have the latest tech?" and "I need better control" (without defining what this means) are not great reasons.
I would consider the value of
- changing basal throughout the day to match your body's needs. If you have some evidence your basal needs vary (such as frequent morning/night time hypos), this would be good.
- changing basal for short periods of time to account for ad hoc variance for exercise or stressful meetings. This was the main reason I qualified for a pump - I would often hypo after exercise.
- need to spread out bolus with your food. Instead of multiple injects for something like pizza (although saying you need a pump in order to eat pizza is probably not a great idea!), the pump provides the flexibility to spread the dose over a few hours.

The other thing to consider is that a pump does not come for free. You need to invest time understanding how to control the pump and you need to be more accurate with carb counting. For this reason, my local team insisted anyone going on a pump must attend a DAFNE-type course. So think about how you can prove you are willing to invest the time and effort to get the best out of a pump.

Sorry if this all sounds a bit much ... I am just speculating. But I have read about people thinking pumps are the saviour to all their diabetes problems and, although it helps a lot, it still requires effort from the patient.

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noblehead said:

It may vary as @himtoo says above

My first appointment after being referred was to discuss which pumps were available through the clinic and to talk through the features of each one, the appointment was quite brief and we booked a further appointment to discuss preparing for the actual start date.

To help prepare you for moving over to a pump do purchase the book Pumping Insulin by John Walsh & Ruth Roberts, it's a must read for anyone on a pump or in the process of moving to one, some of the book may not make sense now but when you actually start pumping insulin it will do @Lordy100

Good luck and hope all goes well.

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Amy993 said:

Mine got resolved within a few months. We first discussed the pump in May, had the first appointment in June, pump trial in July then started in August!

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noblehead said:

If you don't fit the NICE criteria the Consultant can still push for pump funding if you fall under one or more of the ABCD recommendations, here some info on those recommendations:

ABCD recommends that insulin pump therapy is also considered in the following situations:
• Pregnancy
• Acute painful neuropathy or symptomatic autonomic neuropathy if
conventional treatment fails to enable adequate blood glucose control
• Hypoglycaemia unawareness
• Extreme insulin sensitivity
• Needle phobia
• Severe insulin resistance with poor blood glucose control
(especially if type 2)
• Specific quality of life issues:
– Pathological fear of hypoglycaemia
– Marked glycaemic excursions/dawn phenomenon
– Excessive number of injections for optimised control
– Impaired exercise capacity, abnormal eating behaviour or an unacceptable number of sick days
– Shift work or frequent travel across time zones
– In children: sub-optimal school performance, exclusion from aspects of a full school life; behavioural problems (for example, mealtimes); adverse impact on family dynamics

http://www.inputdiabetes.org.uk/alt-insulin-pumps/nhs-funding-pump/

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