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why do some people get the choice of a pump?

LauraC27

Well-Known Member
Messages
96
Location
London
Type of diabetes
Type 1
Treatment type
Insulin
Hello,

I'm type one, diagnosed almost 2 months ago - on insulin, Levemir morning and night, and Novorapid before each meal.
Why do some get the choice of the pump and other's do not? I'm not complaining, i'm just curious!
The pump seems alot less to think about, but also the idea of having something attached to me i'm unsure about...
But this is all new to me, so I don't know! It's just that people keep asking me if i'm using a pump! I had no idea there was such a thing!
 
I was injecting for over 30 years and wasn't happy with my control for over 20 of them before I was offered the pump.

It's only offered to those who can't get decent control on MDI and meet the NICE guidelines.
 
over 20 years!
ok, i understand now. thankyou
 
I got a pump because of nocturnal hypos that couldn't be controlled by adjusting my long acting insulin. It's made a huge difference to my life. It was more a necessity than a choice, I think.

And just to add that a pump is more to think about, not less, I find : D But it's worth it
 
Oh! ok..
why do you find its more to think about? do you mean worries about it coming out etc ? x
 
Some hospitals will now offer children pumps pretty much straight away.

Pumps are actually alot more work than MDI.

I had pump for 5 years but returned to MDI in June as I'm too lean and mean for 6mm cannulas to work well in me.

I would not go back to a pump now. I did love my pump but Indidn't realise until I went back to MDI just how much it took over my life.

My control now remains jyst as good as when I was on the pump but I have my freedom back. I don't have to think about jumping in the bath everyday etc...
 
That's interesting. yeah for children I understand why..
I seem to be managing it ok with insulin right now... but it's early days still.
 
There are positives and negatives associated with pump and MDI. It really depends on what you feel most comfortable with, how your control has been and whether better glucose control can be improved by using a pump that wasn't there before. I think I will try the pump at some stage but for now MDI will suffice.

Also, welcome @LauraC27 and hope you are understanding more about type 1 as each day passes
 
@teacher123

thankyou for your response. yeah i mean, I imagine I will be on insulin injections as long as I'm managing it ok. I just heard of this pump and thought it was the answer to everything.. but seems that isn't entirely the case. I'm not sure of the idea of having something attached to me either... but anyway. see what happens, it's early days and it's not going away! haha so i just have to see how it goes!
 
Precisely.

The most important things in the early stages is that you are monitoring your glucose levels in the morning, before meals, 2 hours after meals and before you go to bed.

Also that your basal (levemir) is the correct dosage - basal should keep your glucose levels stable (no more than 1.6 mol/l drop or rise throughout the day if you didn't eat anything and your bolus (Novorapid) has the correct carbohydrate ratio (carb-counting).

Lots of great information on the forum and any queries just ask away
 
Yeah at the moment it all seems alot to remember. counting carbs is hard.. soon I know it will become second nature and my brain will automatically think in that way.. but right now it's all alot to take in. I'm in the 'honey moon period' right now.. (silly name in my opinion! ) I have been for the past 3 weeks... I'm using levemir morning and night and that seems to be enough to keep me going through the day and night without the novorapid. I need to monitor it closely as I know the sugar levels will start to rise at some point...
how long can this last ?!
as nice as it is now... I would like to be getting into the swing of things too! this little period is making me feel slightly in limbo!
 
The honeymoon period might last a month, 6 months, a year or maybe even longer. I think it depends how you eat and exercise will certainly help too.

If you eat high carbohydrate foods (lots of bread, rice, pasta), takeaways and sugary foods then it won't last very long because you are effectively killing off the remaining cells that produce insulin. If you can reduce your carbohydrate intake then this will prolong the honeymoon period as your pancreas isn't getting a hammering every meal time trying to regulate glucose levels.
 
That's interesting and makes sense! how long did yours last? I'm not a big sugary person anyway..so that part isn't difficult
 
Levemir shouldn't replace Novorapid. If you were to eat less carbs one day you could have some nasty lows. I'd suggest lowering your Levemir and start using Novorapid to meals. If the Levemir can keep you stable throughout the day I'd guess you have a lot of insulin production left. It's possible you could go off basal completely and just take Novorapid to meals.

If you're unsure about dosage there are some rules you can follow to get a rough idea, since you're newly diagnosed I'd recommend contacting your doctor or diabetes nurse so they can help you adjust dosage.

By the way, instead of honeymoon period you can call it remission phase!
 
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You might want to switch your Levemir to morning injections only, I recently did this after re-entering honeymoon (yeah sorry, it can go away and come back ) it's worked well for the past few days. Levemir peaks around 3-4 hours after taking it so if you were to go hypo at least you'd be awake then it would also help you to recognise if you are taking too much. Like @52O342UOIF was saying if you eat less than normal too much Levemir could cause hypos so it's best to use NovoRapid with meals and reduce Levemir.
 
Ok. thanks for your help.
although this is what my diabetic nurse has advised me to do.. just stick with the levemir morning and night. but you are right.. if I eat little later than usual at meal times i do find I can start to feel low. But generally I'm having my meals roughly at the same time each day at the moment (especially during the week because I'm at work etc) so it isn't really causing me a problem. But I do see what you are saying.. I'll speak to my nurse about it. thanks!
 
It's important to remember that dose size makes a very large difference to the action of Levemir. As the clamp graph shows, at doses below 0.2u/kg of body weight, whilst there is a peak, it's incredibly soft and the duration of the action is about eight hours with a long tail where it does very little for the next eight hours. What this means in practice is that it kicks in after about an hour, and I find that it doesn't really have a "sudden" effect. Once you get up to larger doses, the peakiness increases and gets pushed out to about eight hours.



This is why splitting the Levemir dose is a good idea. It reduces the impact of that peak.
 

Do you have any research to back up that statement?
 
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