Hi, wander id anyone can offer some advice. Ive been T1 for 25 years and have never really had ultimate control. Now worse than ever, last Hba1c was 73%. Do you think a pump.would help me finally get control? I see my consultant next week, is it worth asking? Many thanks.
Would a pump help me?Hi
- Thread starter viktoria
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The short answer is "it depends".
It depends on why you struggle with your control.
If it something like the morning liver dump making it difficult to set your basal rates, yes it would: the key value of a pump is that it allows you to set different basal rates at different times of the day.
If it is because you often hypo during exercise, yes it would: you can set temporary basal rates for an hour or more which you can adjust during times when your BG is typically higher or lower.
If it is because you struggle counting your carbs, it will not help: the pump has more control which means you need to be more accurate with your carb counting.
And then you have to consider how you feel about having something attached to you 24x7, how you feel about trusting it for your life, how you feel about attaching a cannula every 3 - 4 days, how you feel about having your diabetes on show (usually, a pump is more obvious than injections unless you have a tubeless one which is typically more expensive), how do you feel about jumping through the hoops to get a pump (this varies per CCG but often you need to go on a DAFNE-type course), how do you feel about setting up the pump when you first get it (this may take some trial and error, time and some problems during the first month or so),...
It is definitely work asking your consultant - they know you and your problems with control better than most of us.
I have a pump and find it very useful but it doesn't come for free.
It depends on why you struggle with your control.
If it something like the morning liver dump making it difficult to set your basal rates, yes it would: the key value of a pump is that it allows you to set different basal rates at different times of the day.
If it is because you often hypo during exercise, yes it would: you can set temporary basal rates for an hour or more which you can adjust during times when your BG is typically higher or lower.
If it is because you struggle counting your carbs, it will not help: the pump has more control which means you need to be more accurate with your carb counting.
And then you have to consider how you feel about having something attached to you 24x7, how you feel about trusting it for your life, how you feel about attaching a cannula every 3 - 4 days, how you feel about having your diabetes on show (usually, a pump is more obvious than injections unless you have a tubeless one which is typically more expensive), how do you feel about jumping through the hoops to get a pump (this varies per CCG but often you need to go on a DAFNE-type course), how do you feel about setting up the pump when you first get it (this may take some trial and error, time and some problems during the first month or so),...
It is definitely work asking your consultant - they know you and your problems with control better than most of us.
I have a pump and find it very useful but it doesn't come for free.
catapillar
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Given the target is to have a hba1c under 6.5% if your hba1c was 73% you'd be dead. Was your hba1c 73mmol/mol? The old school hba1c is expressed as a percentage, the new one isn't.
How are you currently managing on MDI? Have you done all the basics to obtain control on injections? Have you basal tested? Have you been on a DAFNE course and do you carb count? How often through the day do you test? These are basic things that are required for good control whether you are on a pump or injections. Getting used to a pump is a lot of work and if you don't put the work in on MDI I don't see how a pump is going to magically achieve control.
If you are doing all the basics and struggling with particular issues then it would be worth exploring whether a pump can assis with these issues.mthings like dawn phenomenon, extended boluses, temporary basal rates.
How are you currently managing on MDI? Have you done all the basics to obtain control on injections? Have you basal tested? Have you been on a DAFNE course and do you carb count? How often through the day do you test? These are basic things that are required for good control whether you are on a pump or injections. Getting used to a pump is a lot of work and if you don't put the work in on MDI I don't see how a pump is going to magically achieve control.
If you are doing all the basics and struggling with particular issues then it would be worth exploring whether a pump can assis with these issues.mthings like dawn phenomenon, extended boluses, temporary basal rates.
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Hi @viktoria I have to admit that when I started struggling with MDI about 4 years ago my DSN suggested a pump to me, back then I was pretty anti being attached to anything and the thought of then having to rely on a machine to manage my levels seemed like defeat to me, I was testing up to 8/9 times a day, constantly correcting, pre-bolusing for food by about 20 mins, still swinging high/low, it was a daily battle, I finally admitted defeat a year later after doing DAFNE which was one of the pre-requisites for being able to apply for a pump and at that point I was willing to try anything to improve my control, when I finally got approved after battling with the team to get it, well I was over the moon. However even with getting the pump I am still testing just as much and it took around 2-3 months to get ratios adjusted, still now i have to review my insulin ratios regularly, but can see the patterns more easily now, it's been alot of effort to get where I am today. I knew that the pump would change my control but never realised how much, for the reasons stated above, and I now exercise alot more as more confident now to do so.
Using a pump can benefit you, but only if you willing to invest time and energy into making it work for you.
Using a pump can benefit you, but only if you willing to invest time and energy into making it work for you.
NicoleC1971
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Might do and definitely worth thinking about.
It is not a silver bullet so only if you are willing and able to get to grips with basal rates and carb/insulin ratios etc.
I would not be without mine because I feel it allows me a 'smoother ride' because I just have short acting insulin which I can fine tune without worrying about the background insulin running out or peaking.
I believe that the latest research does not show any advantage of a pump over MDI+ Dafne education in terms of HBA1c but all my diab friends feel their quality of life is better.
That said I still long for a cgm that talks to a pump but hopefully that will come by the time I renew my pump in 3 years...
It is not a silver bullet so only if you are willing and able to get to grips with basal rates and carb/insulin ratios etc.
I would not be without mine because I feel it allows me a 'smoother ride' because I just have short acting insulin which I can fine tune without worrying about the background insulin running out or peaking.
I believe that the latest research does not show any advantage of a pump over MDI+ Dafne education in terms of HBA1c but all my diab friends feel their quality of life is better.
That said I still long for a cgm that talks to a pump but hopefully that will come by the time I renew my pump in 3 years...
Hi,
I have only been on a pump for a few months. Before going onto the pump I frequently would hit 25+ mmol/L and the lows, I had my meter say Hi and Lo to me within a few hours and I was greeted by my meter a number of more times than I would have liked.. My HbA1c was 8% and up to just over 9%. Since being on the pumpI have never gone over 19mmol/L had few lows and it's still being adjusted. I had rejected suggestions from my Drs to go onto a pump years ago. My only regret is I didn't do it then. I realise some people will have an issue being attached to a black box (or the omnipod, that I know nothing about as they don't seem to be available in the country I live in Australia). On the rare occasion I need to get up in the middle of the night I automatically pick it up whilst I'm still pretty much asleep. I toss and turn in bed, I just let it wander around in the bed and no problems, that was my biggest fear. It has very quickly become a part of me, I don't feel as I'm on a leash or anything, it's just like wearing a watch (that I wear 24x7). Occasionally it gets loose and is dangling, it hasn't pulled the cannula out yet. You still have to put in a bit of work with what you eat or don't eat, but for a little effort I get an enormous reward.
I have only been on a pump for a few months. Before going onto the pump I frequently would hit 25+ mmol/L and the lows, I had my meter say Hi and Lo to me within a few hours and I was greeted by my meter a number of more times than I would have liked.. My HbA1c was 8% and up to just over 9%. Since being on the pumpI have never gone over 19mmol/L had few lows and it's still being adjusted. I had rejected suggestions from my Drs to go onto a pump years ago. My only regret is I didn't do it then. I realise some people will have an issue being attached to a black box (or the omnipod, that I know nothing about as they don't seem to be available in the country I live in Australia). On the rare occasion I need to get up in the middle of the night I automatically pick it up whilst I'm still pretty much asleep. I toss and turn in bed, I just let it wander around in the bed and no problems, that was my biggest fear. It has very quickly become a part of me, I don't feel as I'm on a leash or anything, it's just like wearing a watch (that I wear 24x7). Occasionally it gets loose and is dangling, it hasn't pulled the cannula out yet. You still have to put in a bit of work with what you eat or don't eat, but for a little effort I get an enormous reward.
novorapidboi26
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I would say it would definitely help you........the preparation before going on one though varies between person to person.....
for example if you haven't had any knowledge and experience of adjusting your own doses on a multiple daily injection regime you are a long way off from making the pump a success, never mind actually getting one...
most health boards will want to see you attempt to achieve decent control with carb counting and dose adjustment techniques....
So what stage are you at....?
for example if you haven't had any knowledge and experience of adjusting your own doses on a multiple daily injection regime you are a long way off from making the pump a success, never mind actually getting one...
most health boards will want to see you attempt to achieve decent control with carb counting and dose adjustment techniques....
So what stage are you at....?
A pump is not a plug and play device,you have to work very hard to make it work.
Yes, it could be a great tool to help you gain better control than you have previously been able to maintain. But, as others have said, it’s a case of you get out of it what you put in. Personally I love the flexibility mine offers, the duel and square bolus‘s are a game changer as are the temp basel rates and multiple basel rates through the day and night.
You can get great results but must invest time and effort into setting things up correctly and constantly reassessing your needs.
CartaX2
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Having been on pre-mixed insulin and injections for 5 years then switching to a pump, I can say that I would not be able to go back to injections. It is not a miracle machine however. You will still have highs and lows occasionally, and all the other stuff that you need to take care of is still relevant (exercise, etc). That said, it provides much more freedom with respect to lifestyle than syringes do.
