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What reason are you on a pump?

That's a good general point in favour of pumps, that you get past the lottery of matching the action profiles of Lantus and Levemir and trying to get them to match your actual basal rate needs. Long acting insulins are very blunt instruments for this purpose. At the absolute best case they assume you need a constant amount of basal per hour, but they don't even do that particularly well. For example, the duration of action of all of them varies according to the size of the dose. Which means an injection schedule that works for a given basal quantity requirement, will no longer work if that person's basal quantity requirements go up or down.

In other words, long acting insulins have struggled for decades yet failed to be able to provide a type of basal coverage which is literally the simplest type of basal coverage that a pump can provide - with extreme reliability and predictability.

I don't know if it's officially part of the reasons for the NHS supporting pumps, but I sense some disenchantment from HCPs with the long acting insulins.

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I got my pump on the NHS more than 10 years ago. I had it because of severe night-time hypos.

My HbA1C was fine (5.2) and has stayed pretty much the same since going on the pump, but it's got rid of those evil night-time hypos which were making me afraid to go to sleep. I felt 10 years younger a couple of days after I got it. I felt I'd got my life back.

I can't imagine not having a pump. I never want to take any long-acting insulin ever again! Spiker, you're absolutely right about long-acting insulins being a blunt instrument. With my pump, I can set varying hourly basal rates throughout the night and that's what my body needs. One hour I have as little as 0.1 units, another hour I have as much as 1 unit. There's no way any long-acting insulin could do that. My GP tried to make me try Lantus but I told her she was missing the point. I didn't want a flat line of action - I needed something that adjusted to my body's needs.
 
It seems that there are many reasons for being put on a pump. I wasnt feeling too optimisic about getting one as my a1c is 7 and the NICE guidelines suggest a higher one to be considered for a pump. But for me to get that 7% it is ruling my life, I have to try really hard just to achieve a mediocre a1c and I want to do better. I also like the idea of reducing the rate when exercising. At the moment I have to eat before swimming, which sort of defies the point. I feel like weight loss would be easier on the pump too. Has anyone else lost weight once pumping?
 
Petsnponies

Pumps demand an awful lot of attention to detail, so if you get one, to be prepared for a fair bit of trial and error and loads of bg testing to get it to work in the way you want it to.

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I got my pump due loss of hypo symptoms, and poor control during exercise. The difference it's made in 6months is great, and I'm still setting it up.


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Hi I lost nearly 15kg when I got my pump, I din't have a good HbA1c though went from the 14's % down to 8.3% within the first few months. It was a combination of me having more energy in that, my blood sugars were more controlled and taking a lot less insulin. On MDI I was on something round 120 units a day, that reduced to 80 units firstly on a pump at the moment I'm on something in the region of 30-50 units a day (8 years later). It also really helps that I can excersise without having to eat or have some lucozade 1st. It does take a lot of practise and even now 8 years on I'm still tinkering away with settings. However in saying that I find being on a pump, now that I have a CGM as well, hugely easier to manage myself and get great control (for me), than being on MDI. At present I put much less effort into my pump than I ever did on MDI, and get better results. If being on MDI is easy and you're not getting good results then you're not doing something right/ putting enough effort in. If you put the same intensive effort in as you do for the mdi you should get at least the same results if not better, but also with more flexibility, and a better quality of life. I really don't like it when people say it's more hard work than mdi, because if you put that same energy and time into starting off your pump ( 6 months full on basal testing, food diaries, adjusting new ratios etc) then by the end of it you should know what you're doing and be able to ease off and enjoy the benefits.
 
I got the pump 3 months ago and don't really fit into any of the NICE guidelines other than quality of life, which my consultant managed to 'fit' me into. My hba1c was good, and so was my control, but I wanted a pump for the freedom it would give me. So my consulant fought for 18 months to get me on it, and only because I have a pump from another girl who tried it for a few months and hated it
 
Please be aware that a pump is not an easy solution, and it will not suit everyone. I love my pump, it has helped me tremendously but it takes more effort (in my opinion) than mdi did.

I got mine because I had tried all of the Basal insulins and would suffer from sudden, severe drops in BG which meant that I would hypo for no discernible reason. I had no hypo awareness and my hypos caused seizures. When my husband was away I would not sleep because I was afraid of having a hypo and never waking up.

My pump has changed my life, but it is not an easy option.


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I also agree with dougal......pumps are very life changing and will demand that we all take better care of ourselves through the need to get the settings correct which can only be done with frequent bg testing every day which then leads on to the desire for cgm.

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You fit the NICE guidelines by being under 18 I suspect, @teen-girl. Congratulations on getting your pump!
 
Spiker said:
You fit the NICE guidelines by being under 18 I suspect, @teen-girl. Congratulations on getting your pump!
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You may be right, maybe its just the area I live in, theres only 3 children on pumps anyway and half of the doctors aren't pump trained, anf thank you I'm loving the pump!
 
Shift worker - working a mix of earlies/lates and nights, random days in the week. Irregular meal times, forgetting to inject and sporadic BGL testing. Went to my registrar, asked for a pump, got one. (Much easier to get one here in Oz than back in UK)!
 
(Much easier to get one here in Oz than back in UK)![/QUOTE]

I wouldn't have said its difficult in the UK unless its a postcode lottery?

My Diabetes consultant recommended me to go on a pump I agreed then 2 months later I was in the process of getting one.

RoDnEyBoY
 
the dawn phenomenon and failure to get below 8% HbA1c............

the consultant had seen the effort I had put in with lots of testing and trying different tactics to get my mid meal numbers down.........so it was an easy decision, I am just thankful the Scottish government had made funding available or it would never of happened......

the reality is that if I cut down my carb intake I would have seen better results......even on injections......

that's the hard bit though....
 
RoDnEyBoY said:
(Much easier to get one here in Oz than back in UK)!
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I wouldn't have said its difficult in the UK unless its a postcode lottery?

My Diabetes consultant recommended me to go on a pump I agreed then 2 months later I was in the process of getting one.

RoDnEyBoY[/QUOTE]
I think that it might be, I'm in the UK as well and I had to wait 18 months for the pump and that's only because I had one that was returned by another girl and they rushed me onto it just before Christmas


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Losing my sight totally in my left eye and partially in my right eye in my early 30s due to proliferative retinopathy. I was trying so hard to keep my blood sugars low on MDI to protect the vision the surgeons had managed to salvage that I lost all hypo awareness, still not regained any 12 years later. I started going unconscious and having fits including whilst waiting in the diabetes clinic and no, I really wasn't trying to make a point! Thank goodness for the NHS in providing access to such great technology and also thank goodness for not having to use Lantus again.
 
teen-girl said:
I wouldn't have said its difficult in the UK unless its a postcode lottery?

My Diabetes consultant recommended me to go on a pump I agreed then 2 months later I was in the process of getting one.
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The people on my DAFNE course and pump course had typically waited 6 months to 2 years. Some more some less. I was told yesterday that the NHS service level is to provide within 3 months.


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I'll be around 15-16 months in my case, so I'm not doing too badly in that case.
 
I was quite annoyed at how long it took for me as I was given unrealistic expectations. I was told about the pump when I was first diagnosed(3 yrs ago), but I hated the idea of it. My doctor kept mentioning it and one day I just decided that I wanted one. I approached my doctor who told me it was great idea and sent me to a pump group thing a couple of weeks later with a company rep and we got to meet pump patients and 'play' with the pumps. I was told that I would be on by the end of that summer before I properly started my GCSE's(I was/am halfway through my 1st year of sixth form now I have it). The dates they promised kept get further away and it was really disheartening. If I was told it would have taken that long to begin with I would have accepted it, but they built my hopes up every clinic appointment to have them crashing down again a few months later. I was only put on in the end as they 'found' a pump from a girl who disliked it after few months, there phoned me up out of the blue and told me I would have one training session that week and then start on new years eve. that was stressful enough as there was no one to talk to.
 
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