Tips to get pump funding

[Type1Bri]

Hi all, I have a DSN appointment on Thursday morning. I want to get on a pump but my last Hba1c was 43mmol/L or 6.3% in old money. I do suffer from DP my FBS is usually 9 and keeps rising until I take 3 units of Novarapid to stop the rise.
Any tips to make the outcome of pump funding more likely would be greatly received

 

[Juicyj]

Hi Bri it very much depends on which trust you fall under as each trust tends to have its own criteria. From my experience within my trust they wanted to see that you fell into one or all of the following categories: attended DAFNE, were maintaining good self management,(i.e. kept HbA1c below a certain threshold), that type 1 had affected your lifestyle, so it had impacted on your work, lost hypo awareness. It's worth having a good chat with your DSN to explain your reasons, it is a lengthy process, mine took a year and went through 2 panels before being accepted, I tried never to get too optimistic it would happen so tried as hard as I could with MDI in the meantime. It may also be worth exploring a different background in the meantime with your DP situation also ? Good luck

 

[himtoo]

my route to a pump is very similar to @Juicyj in terms of time. ( 13 months )
I have suffered with lack of hypo awareness for a number of years though so that tick box along with my consultant actually putting me forward to the pump consultant probably helped.
that would be my tip -- to stress the impact that reduced hypo awareness is having ( if it is indeed happening)

wishing you all the best !!

 

[CarbsRok]

Best thing to do is write down why you think a pump would benefit you, your expectations of the pump and also say you realise how much work is needed and involved with having a pump.
Also show what you have done to sort out the problem with MDI, be prepared to have the run around and be given certain things to try. Don't throw dollies out of the pram when they pile more **** on you as it's just a delaying tactic to hang on to the funding and also to see if you can stand the pressure when things don't go to plan.

Good luck

 

[Snapsy]

My DSN was great and picked up on the quality of life issues related to anxiety surrounding hypoglycaemia. My HbA1c was 44 when we were talking about a pump so that didn't come into the equation.

Hope the appointment goes well! Do report back!

 

[Type1Lad]

Daffyd/dafne course is a must that was the only thing holding me back from getting a pump
other then that tell them why you think it would benefit you and show them how you're trying to controll on mdi with that hba1c you won't fall into the bad controll part has to be above 9% >.<

 

[noblehead]

@Type1Bri, if you don't fit the NICE criteria for moving to a pump see if you fit into the ABCD recommendations:

ABCD recommends that insulin pump therapy is also considered in the following situations:
• Pregnancy
• Acute painful neuropathy or symptomatic autonomic neuropathy if
conventional treatment fails to enable adequate blood glucose control
• Hypoglycaemia unawareness
• Extreme insulin sensitivity
• Needle phobia
• Severe insulin resistance with poor blood glucose control
(especially if type 2)
• Specific quality of life issues:
– Pathological fear of hypoglycaemia
– Marked glycaemic excursions/dawn phenomenon
– Excessive number of injections for optimised control
– Impaired exercise capacity, abnormal eating behaviour or an unacceptable number of sick days
– Shift work or frequent travel across time zones
– In children: sub-optimal school performance, exclusion from aspects of a full school life; behavioural problems (for example, mealtimes); adverse impact on family dynamics

http://www.inputdiabetes.org.uk/alt-insulin-pumps/is-it-provided-by-the-nhs/

Good luck.

 

[Type1Bri]

Thanks for all the advice and tips guys, just had my DSN on the phone and appointment now ben rescheduled for 11th April!!! Suits me though as I know have some time to prepare properly

 

[novorapidboi26]

It looks like your control is actually quite good and hypos aren't a problem but each PCT is different and some are looking to get people on the pump regardless......

Try and get across that on injections , you are already pro active in your approach and are adjusting your own doses, performing basal tests....short of being competent, I am unsure what else you could say to convince them......

There may be a small possibility you are in honeymoon still so it may transpire that your control will get harder to get right and you will actually need to pump.....

good luck.....

 

[Type1Bri]

It looks like your control is actually quite good and hypos aren't a problem but each PCT is different and some are looking to get people on the pump regardless......

Try and get across that on injections , you are already pro active in your approach and are adjusting your own doses, performing basal tests....short of being competent, I am unsure what else you could say to convince them......

There may be a small possibility you are in honeymoon still so it may transpire that your control will get harder to get right and you will actually need to pump.....

good luck.....

Yeah that's much what I am thinking. I am well out of honeymoon now, a missed basal dose the other week proved that too me!! I am going down the route of too many hypos during strenuous work activities are effecting my quality of life I think

 

[novorapidboi26]

Yeah that's much what I am thinking. I am well out of honeymoon now, a missed basal dose the other week proved that too me!! I am going down the route of too many hypos during strenuous work activities are effecting my quality of life I think

That should do it for sure.....

 

[Snapsy]

Yeah that's much what I am thinking. I am well out of honeymoon now, a missed basal dose the other week proved that too me!! I am going down the route of too many hypos during strenuous work activities are effecting my quality of life I think

Your last sentence hits the jackpot, I'd say - but to be absolutely certain I'd lose the 'I think' at the end, when you talk to them in April. Sold!