Pumps??

Hi Gazza,

There is a lot of NICE guidance on who can be put on the pump. It basically boils down to the requirement that the existing multiple injection therapy is failing, e.g. rising HbA1c despite the patients attempts to bring it under control.

Using a pump does mean a lot of work has to be put in by you. :shock: To go on to a pump means you have to carbohydrate count. This means you adjust your insulin doses based on what you are eating and what you are doing. This does mean that pump candidates normally have to undertake some form of carb counting course before they can be issued a pump, e.g. Bertie or Dafne. :wink: Also it's not just about attending, you have to complete it and understand it. This is not for everyone.

I have been on a pump now for nearly 3 years. It does work for me. My HbA1c has dropped to 6.9, but it means that I have to be accurate on carbohydrate counts. Being 10gms out means my bg goes up by 3! It also means overestimating by 10gms means a hypo. I have started Diabetes Friendly Dining to try and make eating out easier.

Good luck. I have found that the pump has made life much more flexible and it really is worth the effort.

I think it depends on where you are. My Hba1c before getting a pump was 6.5 so pretty good but I felt I could get it tighter on a pump. So I explained to my consltant that I wanted one, he put me on a waiting list and 8 months later I got it. Didn't attend a DAFNE course because I taught myself how to carb count etc and I dodn't fancy doing a 'group' thing. Simple!

I low carb (under 40g carb per day) and with that and the pump I find I have great control now - last hba1c was 6.0 so going in the right direction! And it's great not doing injections anymore - 20 years of injecting four times a day into my thighs was beginning to take it's toll!

Katie.

Hi Gazza,

Sorry if what I said about Dafne was misleading. Dafne is not just about carb counting. The other part that is important when starting to use the pump is to "determine the amount of insulin you require to cover the amount of carbohydrate in the food you are about to eat." This is of use whether you are using a pump or not.

When I learnt carb counting 40 years ago, I did not learn things such as insulin/carb ratio. Now I am on a pump I learnt that my insulin carb ratio is 1u to 11gms CHO. Also 1u of insulin drops my BG by 3. This will be different when injecting because of other effects, e.g. pooling. When armed with this info, you can make adjustments to insulin depending on the meal you are eating.

Initially this seems complicated and sometimes frustrating, but long term, as said by Katie, there are both medical and social benefits.

Hope this helps. :wink: