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Why Won't My Diabetes Nurse Let Me Have A Pump?
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<blockquote data-quote="NicoleC1971" data-source="post: 1879893" data-attributes="member: 365308"><p>Hi</p><p></p><p>Firstly I like my pump and would not give it up for precisely the reasons you mention. I think that if I can get hold of FSL then this combo could make a difference to current scorecard (58 even on low carb).</p><p><a href="https://www.diabetes.co.uk/news/2017/mar/unique-trial-compares-insulin-pump-to-mdi-treatment-in-type-1-diabetes-" target="_blank">https://www.diabetes.co.uk/news/2017/mar/unique-trial-compares-insulin-pump-to-mdi-treatment-in-type-1-diabetes-</a></p><p>96419226.html</p><p>This is the study and this site spun it a little differently to other reports I have seen!</p><p>However if you only measure 1 metric (HBA1c) to guage the cost effectiveness and reduction in complications which will be a key clinical goal then MDI vs. PUMP seems to be a draw or that is certainly how a cash strapped CCG looking at HBA1c only may see it.</p><p>With the advent of flash bg monitoring and cgms (if the CCGs ever let us get our hands on them!), there could be better metrics e.g. <strong>'time in range' </strong>would reflect the absence of roller coaster blood sugars that have such a detrimental impact on quality of life. Its also interesting that it is reckoned that a spking blood sugar is reckoned to be worse for you than a steady above average blood sugar. </p><p>However when the research was done, which drew the conclusion that reduction in HbA1c was linked to reduction in complications, in the early 2000 s the new bg tech was not available and as you know the CCGs/NHS are slow to respond where there isn't an RCT to back up what seems like Common Sense.</p></blockquote><p></p>
[QUOTE="NicoleC1971, post: 1879893, member: 365308"] Hi Firstly I like my pump and would not give it up for precisely the reasons you mention. I think that if I can get hold of FSL then this combo could make a difference to current scorecard (58 even on low carb). [URL]https://www.diabetes.co.uk/news/2017/mar/unique-trial-compares-insulin-pump-to-mdi-treatment-in-type-1-diabetes-[/URL] 96419226.html This is the study and this site spun it a little differently to other reports I have seen! However if you only measure 1 metric (HBA1c) to guage the cost effectiveness and reduction in complications which will be a key clinical goal then MDI vs. PUMP seems to be a draw or that is certainly how a cash strapped CCG looking at HBA1c only may see it. With the advent of flash bg monitoring and cgms (if the CCGs ever let us get our hands on them!), there could be better metrics e.g. [B]'time in range' [/B]would reflect the absence of roller coaster blood sugars that have such a detrimental impact on quality of life. Its also interesting that it is reckoned that a spking blood sugar is reckoned to be worse for you than a steady above average blood sugar. However when the research was done, which drew the conclusion that reduction in HbA1c was linked to reduction in complications, in the early 2000 s the new bg tech was not available and as you know the CCGs/NHS are slow to respond where there isn't an RCT to back up what seems like Common Sense. [/QUOTE]
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