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Time frames - how long?

Discussion in 'Insulin Pump Forum' started by SJT1D, Apr 17, 2021.

  1. SJT1D

    SJT1D · Member

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    Hi all,

    I am type 1 diabetic of just over 25 years. Currently taking MDI, but due to some recent issues, and the fact that I am trying to conceive, my hospital team have agreed to support me with insulin pump therapy (yay!).. we have agreed on a closed loop system, and CGM funding will be applied for at the same time.

    I have a hospital appointment in 3 weeks time, and when I spoke to my DSN a few days ago, she said we would have a further discussion about it, and start the paperwork then.

    I know that situations may differ, depending on areas etc, but I wondering what I am looking at regarding process and paperwork?

    I understand that the funding needs to be applied for for both pump and CGM, as well as training needs to be given on using the pump - what is the actual process?

    How have people also found the transition to pump? If it takes months and I fall pregnant in the meantime, will I completely mess up my bloods during the transition period? Obviously, I don't want this to harm the baby (my most recent Hb1Ac was 5.4%), but I don't want to put off trying trying to conceive for a few months, as I am approaching late 30s already.

    Thank you!
     
  2. Juicyj

    Juicyj Type 1 · Expert
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    Hello @SJT1D

    Brilliant news - it’s quite an achievement to get this far. My transition was simple, I got approval and went in for training and started on saline for a week whilst still doing injections to get used to bolus calculations on the pump, then went onto insulin, started on conservative ratios which were gradually tweaked, despite being so keen to get a pump I still had my weak moments when levels were really off so perseverance and resilience are important, it took me a month to get things more balanced and now I do all my adjustments myself without any input, I am on the tandem slim with control IQ and G6 sensor, I get my weekly updates from my G6 app so can see where I need to adjust, has certainly been a great improvement in my control. I get all my consumables direct from the manufacturer when I need them, and that’s all there is to it, but process might be different for your hospital, your DSN should be able to explain the process.
     
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  3. sleepster

    sleepster Type 1 · Well-Known Member

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    Hi @SJT1D, welcome :)
    As you say it can differ, but for me getting my first pump it was a case of "would you like to try a pump?" "ok we'll apply for the funding" a bit further down the line I needed to do carb counting training (my carb counting had been at a different hospital so they needed to make sure I knew what I was doing) and then I had to go for pump training, which is when I got my pump and the only paperwork I had to do was signing an agreement that I would insure the pump, do however many blood tests a day, that sort of thing. I know it can vary but most people have at least a few months wait between starting the process and getting their pump, I was on the priority list at my clinic, and although I can't remember exactly how long I had to wait I know it was in the first half of 2011 when I was asked if I wanted a pump and September 2012 when I got it :nailbiting:
    I know for a lot of clinics you need to have done DAFNE prior to getting a pump, that wasn't a criteria at my clinic though. Have you done DAFNE?
     
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  4. SJT1D

    SJT1D · Member

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    Thank you both :) After all these years, I am both equally excited (this will be an absolute game changer), but also very, very nervous and a little scared.

    @sleepster - yes, I did DAFNE in September 2019, with my current hospital team. As it was less than 2 years ago, my DSN said that I won't need to do it again, until I do a refresher course at the 5 year mark (which is one day, I believe?). In the meantime, my nurse said we will continue to discuss ratios etc in our normal appointments (I'm currently attending appointments every 2-3 months, due to trying to conceive).
     
  5. Chas C

    Chas C Type 1 · Well-Known Member

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    Best wishes, pump plus CGM is a game changer. Moving to a pump on its is is too. The time for setting up properly can vary from around a month to maybe two but having a linked CGM speeds up this process in setting up your basal levels. But even during these weeks/month(s) you will not be out of control just tweeking your levels - something you will need to continue with over time.
     
    #5 Chas C, Apr 18, 2021 at 7:49 AM
    Last edited: Apr 18, 2021
  6. Maco

    Maco Type 1 · Well-Known Member

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    I moved over to a pump + cgm closed loop System in January. I’m using the Medtronic 780G with the guardian 3 CGM. It roughly took me 2 month from being accepted to starting my training. I was told they would fund/approve the pump in early November & my pump training date was the 7th of January which was when I officially went live with my pump.

    I think the biggest issue is the fact that most hospitals aren’t doing face to face group sessions for training & instead they doing small 3-4 people zoom sessions. So basically it’ll come down to how many people in your area/clinic are on the waiting list in front of you. I think I had roughly 2 groups in front of me.
     
  7. Nic97

    Nic97 · Newbie

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    I think it really differs by area and the impact of the pandemic. Within about six weeks I've had my funding approved and pump ordered. My hospital has such a backlog of patients waiting to start their pumps (as it was stopped over lockdown due to nurse redistribution) that I've been told it could be anywhere from 6 months to a year until I can do my training and start. I'd speak to your team and ask. I think if you were to get pregnant then they may speed things up?
     
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  8. sleepster

    sleepster Type 1 · Well-Known Member

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    Yeah, my clinic weren't doing any training for ages and are now doing one-to-one training in person. I've been waiting 7 months for my new pump because they insist I need training but have now finally agreed to let me do it on Teams!
     
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  9. SJT1D

    SJT1D · Member

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    Hi all,
    Thank you for responding :) As I expected, it is pretty dependent on areas etc. I guess I just need to see what happens when I go to the hospital in a couple of weeks.

    Is training done with just your medical team, or with someone from the manufacturer as well?

    Are there any questions that I should ask at my appointment/anything I need to be aware if?

    @Maco - that is the system that I have been offered. I didn't get a choice in pumps at all, as I was told that funding would be given for both a CGM and pump, and so my hospital want a system that will work together. Can I ask how you have found the system, especially with regards to calibrations? Has your insulin dosage changed since being on it? (I've seen that most people seem to be on slightly less insulin per day, since switching?) Are the items (with exception of actual insulin) sent straight from Medtronic themselves, or are they collected on prescription from pharmacy? If sent from Medtronic, how does this work? Have the company themselves been pretty decent?

    Sorry for all the questions, and once again - thank you to everyone who responded - after more than 25 years, and type 1 since childhood, this will just be a massive change!
     
  10. sleepster

    sleepster Type 1 · Well-Known Member

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    Hi again @SJT1D for my training it was mainly done with a Medtronic rep for my first and second pumps, now that I'm on my third and this one is the same as the last one (and I guess because of covid) it's just with a DSN.
    I know your questions about Medtronic are for Maco but I'll share my experience.
    Supplies are ordered from Medtronic (except for insulin and obviously all your test strips etc still come from the pharmacy), you can do it over the phone or on their online shop https://shop.medtronic-diabetes.co.uk/ and I get 3 months-worth at a time.
    The parcel comes from The Netherlands via UPS, although their UK call centre is in Watford. Parcels come within a couple of days, but they suggest you re-order when you are down to 1 months supply - in case of any issues.
    Medtronic themselves are great in my experience, I've had a few pump replacements and they'll get a new pump to you within hours if something has gone wrong. If it's out of hours you have to speak to somebody in the US, so it might be the next day you get your new pump but still pretty good if you ask me. There was some supply problems a while back, I think it was reservoirs they were having trouble with, you can probably find some old threads on the matter if you're bored :D but on the whole, I'm a big fan of Medtronic and can't see myself choosing other pumps over a Medtronic, given the choice.
     
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  11. Maco

    Maco Type 1 · Well-Known Member

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    @SJT1D, Sounds exactly like what happened with me. I didn't get offered a list of pumps or even told I was getting the cgm until I asked. They literally just said your getting the Medtronic 780g.

    So, the 780G is absolutely fantastic. If you search this forum I have done a few reviews on it. My A1C before the pump was 83 & now its down to 47. My time in range which is set at between 4-10 is usually around the 90% mark but I did go a full 14 days 100% in range once. It is NOT a miracle worker though, if you go high say 13+mmol then I personally think the pump really struggles to bring you back into range itself because the auto correction doses are far too small. If this happens ill either grab my insulin pen or just enter fake carbs to bolus with the pump. If your trainer is like mine they will probably tell you something like ' Don't worry about miscounting carbs, the pump will correct it for you'. Yeah it does to a point, but if you eat a pizza and take 100g of carbs but really youve eaten 140g of carbs then from my experience the pump won't be able to help you.

    Calibrations are fine, never had an issue. First two when inserting a new sensor are 6hrs apart then after that its every 12hrs. I usually calibrate when I get up before breakfast, around 1/2pm then again just before bed. That way it wont wake you up before bed. Make sure you fit the sensor somewhere with plenty of fat, I tried the back of the arm and 7 of my sensors failed during warm up. I have to use the love handle area.


    Im using a lot less insulin then I have before, my basal is a lot let because its automatic & my carb ratios have lowered. Id say take a bolus 15-20minutes before you eat but that is probably a personal thing to you.

    I wont explain the Medtronic supply thing as its been done above but what I will add is this. Sensors CANNOT be ordered online, it needs to be done over the phone & they only send 10 sensors at a time so you need to be on the ball. Especially If you have a couple sensors fail because it'll leave you low on stock. You can order replacement failed sensors online but if I remember rightly its restricted to something like 3 replacements every 3 months or something like that, after which you again need to call.
     
  12. searley

    searley Type 1 · Well-Known Member

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    March last year I had a referral from my consultant to the pump clinic

    2 week later I had a letter with an appointment date(telephone).

    Had the appointment and it was agreed I could have the pump

    2 days later call from pump nurse to discuss my pump choice

    August a pump arrived at my house then had call from nurse to say the were emailing me some paperwork to compete and bring on my training day

    30th Sept was training day
     
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