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Pump referral process

ArtemisBow

ArtemisBow

Well-Known Member
Messages
312
Type of diabetes
Type 1
Treatment type
Insulin
At my consultant appointment last week, she said she wanted me considered for a pump. My overall control is good but my husband and I are trying for a baby, and my fasting levels are not currently where they should be for pregnancy. I get hypos if I take my basal up further. I also have very different Novorapid ratios during the day, so I wonder if I have an unusual basal profile that I'm sometimes covering with rapid acting.

I agree with her that a pump may help, but my impression is that the process for approval and setup can take a long time. This wouldn't bother me if we weren't also trying to conceive, as that has its own time pressures!

I'm interested to know from others what the time frames were from when they started the assessment process to you actually pumping? Were you involved in the assessment at all? Did you need to provide any information?
 
I was referred for a pump for specifically the reason you were... Because I was trying to conceive... My circumstances changed during the process; which meant I then decided to hang on for the new Medtronic 640g (which I now have) -- but if I'd not waited I would have been on the pump within three months from the point of referral -- plus they also told me if I'd conceived before the referral had finished then they would have given me a pump straight away; without waiting for the referral at all.

My fasting blood sugars were also my main problem area -- and are vastly better since being on the pump... In fact everything is easier -- I basically love it.

... And yes, I was involved in the assessment process -- but it was just an informal sit down chat rather than any sort of interrogation; and I didn't have to provide any sort of 'hard evidence' -- they basically just wanted to understand what I would feel I would gain from having a pump, and make sure I understood the effort involved in being on one...

Hope that helps; I would wholeheartedly recommend going for it -- ask any questions! :-)
 
Thanks fellow Artemis, that's really helpful. The work involved does not put me off, I'm already investing a lot of time under MDI in trying to improve my levels and understand what isn't working.

My main concern is if I were put onto a pump then my control might initially be worse during the training period, and if I was pregnant at the same time this would be pretty bad. Ideally I'd be all set up and pumping successfully before falling pregnant, but as no one knows for definite how long either of those takes I'll just have to wing it!
 
I understand; my concern was the same too... If it helps any they reckon my first month pumping shows a predicted hba1c of 6.5 -- previously it was 6.1... So yes it may have gone up (I've definitely had times running higher than normal whilst I adjust) but it's not looking like it's likely to be a dramatic swing and I'd hope will improve from here... It is a lot of effort but sounds like you'll do just fine with that part -- and control further along would be better if you did become pregnant before you got settled on the pump... I was in your shoes 6 months back with the same concerns; and now I'm on the 'other side' (albeit not pregnant!) then I'd definitely still say go for it...x
 
Took around 4 months from my consultant putting my name forward for a pump to actually using one, the good thing about a pump is the ability to adjust your basal rate up to several times a day to match your bodies needs, it could be that you were making up for a shortfall in basal using your Novorapid insulin @ArtemisBow but some people do find that they have a different I:C ratio from morning through to night.
 
I started going through the process in February 2014 and began pumping in November 2014. Not too long but longer than some. Seemed like an age at the time.
 
I am pregnant with no 4 and this is the first pregnancy I've had a pump for. I was not offered and did not want one the last times as felt my levels were acceptable with enough strict low carbing. That doesn't meant I didn't get the occasional high or points of staying just above ideal levels but thankfully all my children were born healthy without any diabetes related complications. Your hba1c looks good enough to start ttc in my hospital.

This time the pregnancy was unplanned and when I called my consultant in a complete funk I asked for a pump that could control everything as per the newspaper reports as I couldn't face going through the level of restraint required again. I got a pump 5 weeks later and it probably would have been just under 4 from my phone request if not for the fact I insisted on sticking with porcine insulin which caused them some arguments with the pump companies.

It has taken some getting used to and while I have days where I am getting great readings I have other days which are a lot more complicated and have been having a lot of problems with infusion sets.

My advice would be to start taking folic acid at 5mg (prescription only) and try to conceive while waiting. if you get pregnant you get the pump faster and if you don't you have something to look forward to. Unfortunately you have no idea how long it will take to get pregnant. I got pregnant very easily 3 times (this time rather too easily while on contraception!) but had great difficulty with one pregnancy where it took me 22 months to conceive.
 
Thanks tigger - I've already been taking the folic acid for 3 months and we've been trying anyway - I didn't expect to be offered a pump as my HbA1c is 6.2, and I thought it had to be a lot higher before you'd be considered. But I think the fact that I have been very strict on diet, been very engaged in my readings and so on and have not managed to get fasting levels lower is what triggered the offer.

I've agreed with the consultant that we'll continue trying to conceive regardless, and if we get lucky they'll try to fast track it as you've done - I just didn't realise how fast that could be!
 
It might be even quicker for you if you're already in the queue...
My hospital is quite pro pump but the other major advantage to it is that you have a much better chance of keeping your range much more stable with less drastic highs and lows (most of the time). This is meant to be much better for the baby so maybe they prioritise you if you are pregnant.

My hba1c on getting pregnant this time was 7.5% which wasn't ideal but not dreadful in relative terms. In terms of criteria I think they may have used hypo unawareness as one. I haven't had it this time but in previous pregnancies when running very tight control have had bad nighttime comas in the first trimester. I think I really got it because my consultant is supportive of me and pumps and knows I'm very careful when it comes to pregnancy and reasonably careful the rest of the time and therefore I assume a good candidate.
 
My story is similar to yours @ArtemisBow I went to my DSN beginning of January last year, I was pumping by feb.

At the clinic I go to they have a loan pump so I was given that to use within a few days of my first appt then I had to let them know if I definitely wanted one so they could order mine, it didn't take me long to make up my mind lol

I could never get fasting bg in single figures on MDI but now I rarely wake up above 5.5, I was probably one of the lucky ones I didn't have to play around with ratios very much at all when I first got it, over time I have as I've changed to way I eat/lifestyle etc but I couldn't be without mine now x
 
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