Well this is a shock!

[oldgreymare]

I received an email from my diabetes clinic yesterday to say that I have been approved for a pump on the NHS. This was a big surprise as my HbA1cs' on MDI over the last 18 months have averaged 46 (6.4%). Although I had asked for one back in February, I really didn't expect a look-in especially given that Hybrid Closed Loop (HCL) tech is going ahead for the NHS with a massive 5 yr rollout plan. I do self fund a Dexcom G7 (previously a G6) which I use 90% of the time and share my data with the clinic, am diligent about attending both GP & clinic appointments, etc. I now need to find out when the pump will be available and training days. It will be standalone, not HCL enabled, but I'm fine with that.

Using my Dexcom I had identified a pattern of nighttime hypos and I suffer from quite severe dawn phenomenon starting from 4-5 am. Constantly trying to correct both has worsened my already poor sleep habits. This is in spite of many attempts to readjust my basal insulin. I'm assuming this swung the decision in my favour, but who knows?

 

[Nicola M]

Your night time hypos and the dawn phenomenon has most definitely contributed to their decisions and I’m only saying this because when I was put forward for an insulin pump it was because after wearing a hospital provided CGM for a week they could see I was hypo pretty much for the entire night even after adjusting my basal insulin and my dawn phenomenon was awful, no matter what I did I always suffered with it.

I’m happy they have seen sense and decided to provide you with one, it’s one thing saying you have a good HbA1c but at what cost to your daily life does that have to come at (lost sleep etc).

 

[Rokaab]

Using my Dexcom I had identified a pattern of nighttime hypos and I suffer from quite severe dawn phenomenon starting from 4-5 am. Constantly trying to correct both has worsened my already poor sleep habits.

Yep that was pretty much why I got one (in 2020), admittedly also mostly helped by the fact that the old consultant retired so I got a new one who immediately saw that I needed one given the above

 

[Hopeful34]

That's great news @oldgreymare
If you're paying for Dexcom yourself I'm a bit puzzled why the pump won't be HCL enabled?

 

[EllieM]

That's great news @oldgreymare
If you're paying for Dexcom yourself I'm a bit puzzled why the pump won't be HCL enabled?

Doesn't it depend on the type of pump???

 

[Hopeful34]

Yes, but just wondered if it was because Dexcom was self funded?? The tslim pump seems to be available for a lot if people, but I know not everyone is offered it of course.

 

[oldgreymare]

Hi @Hopeful34 and @EllieM,

My clinic is at quite a big diabetes research centre attached to a teaching hospital, so perhaps not unexpected that I have been offered a choice of 5 pumps (MiniMed 780G, T-Slim, Dana 1, Ypso Pump and Omnipod DASH). However ever since diagnosis I've resisted the option of using a pump due to a phobia about having tubing attached to my body. So the obvious choice for me is the tubeless Omnipod. The DASH version is not HCL capable but the Omnipod 5 is, and apparently apparently the pump cost is the same for either (not sure about their consumables).

I'm a bit of a control freak, so in many ways I will be happier to learn in depth how to put together the manual programming for my personal profile first (also I'm overdue tightening up my carb and protein counting, calculating various I:C ratios and correction doses).

Also tech issues - I've been using a G7 for over a year and would be loathed to have to revert to the 2 piece G6 system (it's also more expensive to self fund than the G7). I am a diehard iPhone user and have very recently upgraded my phone to an iPhone 15. Dexcom has not yet released the compatible App, so I'll also be carrying around the old phone to act as a G7 receiver for the time being. Plus Insulet, the US manufacturer of Omnipod, has only just received FDA approval to link their Omnipod App directly to an iPhone, with USA rollout planned for 2024. No news on when UK rollout could happen. So I am assuming it could be 18-24 months before I could use my tech for HCL in any event.

I will ask the clinic whether it is possible to be prescribed the Omnipod 5 instead of the DASH, but with the intention to run it in manual mode only, until my tech is compatible to try out HCL. Let's see.

 

[Juicyj]

Amazing news, that's fantastic, I suspect you wont be self funding once you get your pump, I self funded the G6 and once I moved onto the T Slim I was granted funding for this too which was a life saver as it was a big commitment each month, also a good selection to choose from too, exciting stuff.