What do you think my chances are? Any advice?

[Claire007]

i have an appointment with a consultant next week regarding a pump. I haven't met this particular consultant before, my consultant referred me to her.
So, current situation, I self fund the libre and my control is fairly good. However, I suffer from dawn phenomenon (BG drops to around 4 then gradually rises from 3am and is usually between 10 & 12 on waking.
My levemir also seems to run out by around 7pm where it gradually rises to around BG10 before bed. So I correct at bed time every night then every morning.
Ratio is 1:20g of carb (humalog)
4.5 units of levemir am, 5 units pm.
I'm putting my case forward under grounds of dawn phenomenon and insulin sensitivity.

I appreciate the DP isn't massive, but I feel I'm doing everything I can, been on dafne, carb count, self fund libre at great expense etc.
I also really restrict myself re certain foods/snacks/avoid eating at times when I just can't be ***** to inject. I have seen a clinical psychologist. (Didn't really help)

The libre has worked really well for me, typically though I've had a nightmare for the last month with inaccurate readings. I've had the sensors replaced (3 of them!) but my data is all over the shop. They are now sending me a new reader so I'm going to have ****** all data to show at the appointment.

Thanks for reading.
I think chances are slim to nothing!

 

[noblehead]

I disagree, I'd say your changes are rather good given your problems with DP, plus don't forget that your current regime is effecting your quality of life, that too comes under the ABCD recommendations:

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

 

[Claire007]

Thanks, fingers crossed!
I'll let you know how I get on!

 

[CapnGrumpy]

If you go to the appointment thinking your chances are slim, then that may reduce your chances.

Have a look at the guidelines on INPUT's website: http://www.inputdiabetes.org.uk/alt-insulin-pumps/is-it-provided-by-the-nhs/

Then _make_ your experiences match more than one criteria. Sit down and write them down on a piece of paper as bullet points. Then read them again and see if they make sense so that you can refer to them easily at the appointment and don't leave anything out.

 

[Mavcon]

I was on levemir and novorapid for the last year. Levemir seemed to do nothing for me as my basal rate remained high. I was regularly in the 17-25 range. I started a pump this past Saturday and what a shock. I am consistently in the 5-7 range now. They have decreased my IC rate today and lowered my insulin basal rate. I will admit, be prepared for the fatigue for the first couple of days but I feel like a new man. I also use the Dexcom CGM so if you can find a way to finance it (insurance or otherwise ) it has changed my diabetes life.

 

[Snapsy]

@Claire007 ditto what @noblehead has said about quality of life issues.

I didn't fit the criteria and my HbA1c was 42 pre-pump. But to achieve that I was in constant fear of hypos, and I'd set myself ridiculous boundaries to stay within a very narrow range of blood sugar levels, and I seldom went out alone due to a lack of confidence in being safe.

I wrote my DSN a long essay, and saw her as often as I could (she's amazing). After spending a lot of time with me she put the pump question to my consultant, who when I saw him in July 2015 agreed that the CCG could be approached for funding. It was a YES.

Started pumping in October 2015. My life is unrecognisable. I have freedom. I go running. I have confidence in my ability to be well.

With hindsight I had been 'suffering' for years from a compromised quality of life - self-inflicted, sure - it was my choice to be so, so careful - but I had no idea that there was another option. For YEARS I mused over the NICE guidelines, and KNEW I didn't fit them.

But I got my pump, thanks to the ABCD criteria mentioned by @noblehead

All the best with it - pumping was definitely the way to go for me.

 

[azure]

No one can know for,sure, but I think you have a good chance

Before you appointment, get it clear exactly why you need the pump and have evidence to prove what you're saying. I can't see any reason why you don't have a good chance - good luck

 

[T1Dad]

hey are now sending me a new reader so I'm going to have ****** all data to show at the appointment.

Before ditching your old reader connect it up to Diasend and get all the data uploaded there.

 

[Claire007]

Well.....................
It was a yes! Albeit after a bit of umming and arring!
Typically my computer hadn't shut down properly so the data I uploaded before sending my meter back was lost, but given my last 3 sensors were all over the shop I didn't feel it was a true reflection. She did have some data from last October though. So I set out my case as described above along with insulin sensitivity.
She let me describe my life as a diabetic, what the impact was etc as well as asking me to explain the thinking behind decisions i'd made re correction doses/ ratios etc. I felt she was kind of testing my knowledge for how I'd cope with a pump, (being fairly new to this!)
My hba1c has been slowly rising (42 to 52) & I do think DP has impacted on this so the target is to get it to 48.
So! Eek!
She said I'd get to try it out for a week just using saline before fully committing.
It will be a roche insight. She said they offer extremely good customer service and it's her preferred option. Thoughts?
I shall be avidly reading the pump forum!

Thank you, as ever for your support, and if anyone has any recommended reading prior to switching over I'd be grateful.

 

[noblehead]

That is great news @Claire007

Get reading that book Pumping Insulin in preparation for the change over, keep us updated on your progress.