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Thinking about moving to the pump

Discussion in 'Insulin Pump Forum' started by EK297, Jul 14, 2021.

  1. EK297

    EK297 · Member

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    Hi everyone!

    I’ve been T1 diabetic for near 30 years now. Currently on MDI but am wanting to move to the pump. Reasons for wanting to do this include better control, greater predictability of insulin absorption, more flexibility, reduce MDI.

    I’ve been mentioned to my diabetes for a couple of years now but it feels like I am banging my head against a brick wall!

    For those of you who have moved to a pump, what has the process been? I’ve researched already the different pump options available, attended a DAFNE course not long after being diagnosed, have lived with diabetes for many years so know how to carb count etc.

    And, what pumps are people using and what do you like/not like about them?

    Thanks in advance!
    Em
     
  2. Rokaab

    Rokaab Type 1 · Well-Known Member

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    I know I had a complete fight getting a pump, in my area at least they will only give them out if you have a very good reason that cannot be dealt with using MDI, in my case it was my uncontrollable night time sugar levels - my sugar level would drop slowly til 3am and then went up like a rocket ship (80% of the time, so not always) til about 6am, and this cant be dealt with by MDI unless I get up at 3-4am every morning which well would leave me in no state to work or do anything for the rest of the day, and it still took the pump consultant at my hospital retiring and another one replacing home before I was told yes.
    Some areas may be not quite so tough though.

    As for the pumps, it may well depend on what your hospital/clinic offers, mine was a choice of one unless you have very very very good reason to get one that worked with sensors and then it was a choice of one for that as well, but I've read many hospitals have more choice than mine, but you may find you may not be able to get the one you want.

    Note, I finally got started on my pump last year, so my experience is fairly recent, but yes I've seen other experiences mentioned in these forums where its been much easier for people :)

    I'm using the Medtronic 670g, it does work with sensors and has an auto-mode so deals with my unpredictable night time adventures of my blood sugar levels fairly well, its the only one I've used (so cant compare with any others) and I'm loving having a pump, I took to it like a duck to water :)
     
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  3. EK297

    EK297 · Member

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    Thanks, @Rokaab. Here, we have (in theory, at least!) a choice of the OmniPod Dash or the Medtronic 670. I like the look of the OmniPod as it is tubeless but open to either.

    Like you, I find my night-time levels unpredictable. Last night, I went to bed and my sugars were 5.7 and steady. Usual dose of Levemir. Woke up in the night and they were in the 20s! Had to check I had taken my insulin - definitely had! The night before, I went to bed with similar levels. Had eaten the same meal and at a very similar time. My Libre alarm went off three times during the night to tell me my levels were going low.

    It feels like my insulin is absorbed differently each time I inject at the minute, and it’s becoming harder and harder to predict. Driving me up the wall a bit!

    Anyway, glad you finally managed to get a pump and that it’s working well for you.

    Do you mind me asking which part of the country you’re from? Seems to be such a difference from one area to the next in terms of accessing pumps, Libres etc

    Em
     
  4. Rokaab

    Rokaab Type 1 · Well-Known Member

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    I'm in the Reading area so covered by the Berkshire West CCG (who were not fast at getting the libres approved either)
     
  5. EK297

    EK297 · Member

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    I’m up in Northumberland. They were fantastic at getting the Libre. The pump, though… not so much!
     
  6. searley

    searley Type 1 · Moderator
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    They normally have criteria you need to meet to be offered a pump. And high bg alone may not be enough.. they will argue that if you have unpredictable levels like that.. they you’ll have the same on the pump.. the omnipod does not dose adjust for you.. so you’ll still wake up in the night sometimes high..

    So I doubt that alone will get you a pump
     
  7. sleepster

    sleepster Type 1 · Well-Known Member

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    Hello @EK297, I'm in Newcastle :D
    I'd be inclined to say that if your team are not responsive to your mentions of a pump it's because they don't think you'd meet the criteria, but you might have to be direct and just ask them what the criteria are and if you meet them.
     
  8. EK297

    EK297 · Member

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    Totally understand they there will be criteria - not clear what they are for this area (at least not clear to me). If it’s the case that I’m not meeting the criteria I’d be happy for them just to say that. Just feels like nobody is owning the request, if that makes sense. Getting passed in circles snd getting nowhere!
     
  9. EK297

    EK297 · Member

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    Asked and the lass I spoke to didn’t know the criteria - she was going to ask the consultant who would then get back to me!

    I’ve got a follow up appointment over the phone next week so will be asking again then.

    Are you under the care of the team at the old General hospital? I’m on the border of Northumberland and Newcastle do that’s where I go :)
     
  10. searley

    searley Type 1 · Moderator
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    The general guidelines are set by nice.

    Search Google for. ‘Nice insulin pump criteria ‘
     
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  11. sleepster

    sleepster Type 1 · Well-Known Member

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    Ah yes, they do seem to be a bit...not very good at communicating with each other :hilarious:
    Yeah I changed to this hospital from UHND (where I first got my pump) last year, but went to this one ages ago, when it was still the General. I thought if I changed hospitals when I moved I might not get another pump but my consultant is lovely and I got a new one earlier this year :)
     
  12. username3

    username3 · Member

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    The pump is a great advancement, I would recommend it. You might need to really wrestle with your team for one, reason being - it's expensive. But it's definitely superior technology. The issue is, if you are able to manage your diabetes well on injections, then you are not most likely to be eligible for one.
     
  13. Kevlar87

    Kevlar87 Type 1 · Well-Known Member

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    This is the exact same reason my consultant was happy to put me on the waiting list. I'd inject levemir before bed and my BGs would be totally fine up until 3-4am and then my BGs would just shoot up and unless I wake up at around 530am and inject some novorapid correction, by breakfast I'd see BGs in the range of 16-17. I just got so frustrated with the constant small correction doses every few hours in the morning. I'm even on metformin because my consultant felt like it would help reduce my insulin resistance and reduce my overall insulin levels (it has actually worked in reducing my insulin amounts but those morning BGs/dawn phenomenon are still troublesome).

    I've been given the option of medtronic 780G, omnipod dash, and tandem t:slim. I like the idea of having the closed loop system but these things are quite bulky and as I do a lot of sports I feel a sense of panic as just thinking they might fall and break or stop me from playing footy/squash/hiking with comfort. The omnipod looks nice and as I've only recently switched over to the freestyle libre I feel together they could be a good combination.

    Does anyone have any experience of the libre and omnipod?
     
  14. Soplewis12

    Soplewis12 Type 1 · Well-Known Member

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    Hiya, I started omnipod dash & libre 2 in March this year. A lot of work to begin with to get basal rate correct, I've got 6 different rates throughout the day. My bolus rates remained the same for meals.
    As only using fast acting insulin it is a lot more sensitive & quite unforgiving.
    Exercise is much easier to handle.
    You can suspend insulin if quickly going low.
    Can have up to 12 basal rates set up.
    Can have a number of daily basal rates, e.g. work day, weekend, etc
    Can set temp basal rates, e.g. I have a housework one, a walk, food shop, gym, illness, etc. Can extend bolus if food more difficult to digest, ie fatty/high protein foods.
    Only downsides for me personally have been, hypo'd frequently during summer heatwave (never happened when on MDI). Eventually worked out how much less insulin I needed.
    More hypo's soon after eating until I used extended bolus for all teatime meals.
    It is extremely hard work to begin with, my Pump Specialist Nurse indicated a bedding in period of 1 month, this was not the case for me I'd say 3-6 months. It's just like being freshly diagnosed as so many factors to be considered.
    I thought it was going to be the answer to my prayers but its not, still have some highs & lows but it does help. It would be impossible to use without the libre. My pump consultant readily admits it is more work using a pump than MDI.
    Dont hesitate to ask if you have any specific questions
     
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  15. Kevlar87

    Kevlar87 Type 1 · Well-Known Member

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    Thanks for this insight! I'm a little worried now that I may be trying to solve a problem that the pump won't actually solve but will make much more complicated! I guess the continuous fast acting insulin may help with controlling my dawn phenomenon with the right temp basal settings?
     
  16. Soplewis12

    Soplewis12 Type 1 · Well-Known Member

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    Hiya
    It will be a massive help with this. In the first week we had to check our BG every 2 hours including through the night, so you get good insight in to what your body needs. It has massively improved my night time sleep. I never suffered from dawn phenomenon but would frequently wake in hypo through the night, no matter what juggling I did with the lantus dosages. I can now go to sleep much more confident of a sound sleep. I found the pump frustrating to begin with but I am a bit of a control freak with diabetes (that's a laugh in itself!) but you might take to it like a duck to water, it just took longer for me to find my mojo.
    It is just another learning curve but you will get to an even keel with it.
    Best of luck!
     
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