Thinking of getting a pump

[Torzy]

I have been diabetic for a few years now and i am currently using the Dexcom one sensor. I love this sensor. Im finding it difficult to control my blood sugars and will be talking to my consultant on having a insulin pump. What are the pros and cons of this? Is it easy to apply? Does it hurt? was it difficult to get on the NHS??

 

[In Response]

Pros
- able to alter basal every 30 minutes
- able to dose 0.05 units at a time

Cons
- requires more effort to get dose correct
- can fail and never fails at a good time
- more stuff to carry around

Changing sets (attaching pump)
- need to do it every 3 days
- ease varies per pump

Pain
- nope, my current pump I can’t tell it is there

Jow to get on NHS
- need to have a very good reason why you are struggling to manage your levels with MDI.
- most clinics require you to undertake the DAFNE course (or local equivalent)
- read the NICE guidelines for criteria
- (note: ut must be prescribed by a consultant In the UK. You cannot just buy one. You could go private but it is very costly.


You say you are struggling to control your diabetes. Firstly, diabetes cannot be controlled. It can be managed. If you are trying to control it at all times, you will fail.
That said, what are you struggling with? A pump is not a silver bullet. You still need to carb count. The pump is just another way to administer insulin,

 

[Torzy]

Thank you for your reply.
I have undertaken the DAFNE course 6 months after i was diagnosed. Really helped.

Im struggling with keeping it within range. Sometimes my body just what it seems like wont absorb the insulin and i constantly run HIgh. Then some days i'm constantly hypoing.

You say more things to carry around, what is it that you need to carry with you?

another reason for wanting a pump is because i want to become pregnant. My HBA1c is high. last blood test was 61. After speaking to a nurse, she advised it may be worth looking into a pump as i may get better management for it.

 

[In Response]

You say more things to carry around, what is it that you need to carry with you?

I need pump changes in case the cannula fails.
For a few hours, I carry a syringe and a vial of insulin but, if I got overnight, I also carry my insulin pens in case the pump fails.
And, when going away overnight, I will take twice as much of everything including pump sets.

 

[Torzy]

I need pump changes in case the cannula fails.
For a few hours, I carry a syringe and a vial of insulin but, if I got overnight, I also carry my insulin pens in case the pump fails.
And, when going away overnight, I will take twice as much of everything including pump sets.

How long have you been on the pump for? And had it helped you?
I know nothing is a quick fix for this condition but I want to make my life a little easier and hopefully stop the Hypos while I'm at work.

 

[Steveee]

I have been diabetic for a few years now and i am currently using the Dexcom one sensor. I love this sensor. Im finding it difficult to control my blood sugars and will be talking to my consultant on having a insulin pump. What are the pros and cons of this? Is it easy to apply? Does it hurt? was it difficult to get on the NHS??

Hi, I’m on my 5th insulin pump so my pov is positive. Over the 15+ years I’ve used it they technology has changed and improved a lot and is about to take a big step forward with the 1st commercial hybrid loop pumps starting to become available on the NHS.
Like you I was struggling with control before I started on the pump.
Is it painful: similar to injecting so no. Is it easy to apply: most modern pumps have an applicator for the cannula. Is it difficult to get: really depends on your local ICS and the criteria they use. Yes, they should follow NICE guidelines, but as these are guidelines, many apply them and some add additional restrictions. If you struggle with control, or have lots of hypos because you’re trying to get your HbA1c down, this is often a reason.
PROS: you can profile your basal rate far closer to your real background need. This will reduce number of hypos under normal circumstances.
You can bolus precisely to the carbs you’re eating, even doing a fraction of a unit.
You can do an extended bolus (deliver bolus over multiple hours) to match the glycaemic index of the food. For instance, for a pasta meal I bolus 60% immediately and 50% over 4:40 hours!
You can adjust basal rate for different types of exercise. You need different basal depending on aerobic vs anaerobic exercise.
You only need to change cannula every 2-3 days, e.g. you don’t have to excuse yourself to do a jab when eating out.
Basically it allows you to be more flexible.
CONS: because basal insulin is fast acting, if it stopped, you quickly go hyperglycemic.
The modern pumps and associated apps do a lot of the maths for you, but you have to think all the time about how many carbs you’re eating and the type of carbs.
When travelling, you have to carry a lot more equipment, eg spare insulin reservoirs (each typically only 160U), spare cannulas and tubing, backup insulin pens incase pump fails, spare batteries or charging cable.
Most pump teams will require you to do a DAFNE course before starting. Needed to get your insulin sensitivity and basal requirements calculated. Means you will have to take time off work for this training.

 

[In Response]

spare insulin reservoirs (each typically only 160U)

I have had two different pumps.
Both have a capacity of 200U. I understand there are some that take 300U but as I use less than 120U in three days, I have never looked much at these. Likewise, I have avoided pre-filled cartridges.

Means you will have to take time off work for this training.

My DAFNE equivalent course was after work, one evening a week for 6 weeks. It is not always necessary to take time off work.

I guess what we are showing is, if you think you will benefit from a pump (not just that you want one) you need to discuss pump options and criteria with your clinic because there are many variations.

 

[Torzy]

Hi, I’m on my 5th insulin pump so my pov is positive. Over the 15+ years I’ve used it they technology has changed and improved a lot and is about to take a big step forward with the 1st commercial hybrid loop pumps starting to become available on the NHS.
Like you I was struggling with control before I started on the pump.
Is it painful: similar to injecting so no. Is it easy to apply: most modern pumps have an applicator for the cannula. Is it difficult to get: really depends on your local ICS and the criteria they use. Yes, they should follow NICE guidelines, but as these are guidelines, many apply them and some add additional restrictions. If you struggle with control, or have lots of hypos because you’re trying to get your HbA1c down, this is often a reason.
PROS: you can profile your basal rate far closer to your real background need. This will reduce number of hypos under normal circumstances.
You can bolus precisely to the carbs you’re eating, even doing a fraction of a unit.
You can do an extended bolus (deliver bolus over multiple hours) to match the glycaemic index of the food. For instance, for a pasta meal I bolus 60% immediately and 50% over 4:40 hours!
You can adjust basal rate for different types of exercise. You need different basal depending on aerobic vs anaerobic exercise.
You only need to change cannula every 2-3 days, e.g. you don’t have to excuse yourself to do a jab when eating out.
Basically it allows you to be more flexible.
CONS: because basal insulin is fast acting, if it stopped, you quickly go hyperglycemic.
The modern pumps and associated apps do a lot of the maths for you, but you have to think all the time about how many carbs you’re eating and the type of carbs.
When travelling, you have to carry a lot more equipment, eg spare insulin reservoirs (each typically only 160U), spare cannulas and tubing, backup insulin pens incase pump fails, spare batteries or charging cable.
Most pump teams will require you to do a DAFNE course before starting. Needed to get your insulin sensitivity and basal requirements calculated. Means you will have to take time off work for this training.

I have already done the DAFNE course. I did it about 7months after being diagnosed.

I'm still on the fence wether I want to go down the pump route. I am finding that I'm having a second wave of sugar that makes my blood sugar go high. So having the moverbility to have slower release etc does seem very good.
I also run for exercise..does this help with that also?

What do you do when you go in the pool?

 

[Torzy]

I have had two different pumps.
Both have a capacity of 200U. I understand there are some that take 300U but as I use less than 120U in three days, I have never looked much at these. Likewise, I have avoided pre-filled cartridges.


My DAFNE equivalent course was after work, one evening a week for 6 weeks. It is not always necessary to take time off work.

I guess what we are showing is, if you think you will benefit from a pump (not just that you want one) you need to discuss pump options and criteria with your clinic because there are many variations.

I do think I will benefit from having one and have done some research. This is some thing I will be discussing on the 21st with my consultant.
Its always nice having personal opinions also.

 

[In Response]

What do you do when you go in the pool?

Depends on the type of pump you have.
You can keep your pump attached, especially if it is a patch pump.
Or you could detach a tubed pump.

It depends how long you are in the pool and what impact it has on your levels.

 

[Torzy]

Depends on the type of pump you have.
You can keep your pump attached, especially if it is a patch pump.
Or you could detach a tubed pump.

It depends how long you are in the pool and what impact it has on your levels.

I do enjoy swimming and would stay in for atleast 45mins. Swimming does make me hypo though.