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Would using a pump be safer for me?

Discussion in 'Insulin Pump Forum' started by Anthony_H, Sep 13, 2017.

  1. Anthony_H

    Anthony_H Type 1 · Member

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    Hi all.
    I've only been diagnosed with diabetes for 2.5 weeks and it appears "highly likely" it's T1.
    I also have to deal with narcolepsy and cataplexy
    My concern with the current method of pen injecting is that if I have a sleep attack during dialling up my pen doses that I could end up under or overdosing and wouldn't know. I'm not technically sleeping as one would normally think of it but I am dreaming, eyes open. An example is counting out 10p coins into stacks of 10. My wife came up beside me and asked what I was doing so I told her. She asked why there were 2p coins and 20p coins in the same pile? At that point I became aware of what I'd done. It's strange I know but hallucinations/unbelievably vivid dreams are part of the cause.
    I once drove an estimated 1-1.5 miles on a straight stretch of the M74 asleep!! The neurologist said I would have had my eyes open and tramlining the white lines in auto mode. He reckoned any curve in the road would've ended in disaster.....that was my first ever experience of narcolepsy. Needless to say, I haven't driven in more than 6 years after making the decision myself that I wasn't safe to be in control of a vehicle on public roads.

    So, I have discussed this with numerous people, professionals an family and friends. From the hospital perspective they have given me a Novo 5 pen which has the digital readout showing the last injection dose. This won't stop me from dialling incorrectly but may allow enough time to correct the situation if checked in time? This only works with novo rapid though and not lantis....different manufacturer.
    So my long acting dose is via a conventional disposable pen and zero safeguards. The hospital suggested I change the time I inject it so that my wife is able to monitor me which I have to early evening but there will be times she isn't going to be there.....?

    It's been suggested that an infusion pump may be a safer alternative?
    Does a pump potentially allow under or overdosing to a harmful extent or am I correct in thinking they have in built safety parameters which stop it happening. I'm not on about 1 or 2 extra units.....more like dialling in 40 instead of 4 type of thing. Frankly it could be any number.

    Thanks for reading
    Regards, Anthony
     
  2. Crystalwand

    Crystalwand Type 1 · Well-Known Member

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    I have had my pump for six weeks now omnipod, you have to pre set the amount, think about it being you own pancreas, it drips all day for three days, but you do have to set the dose I worth a chat with your team and what they say ( ps look online, or get your wife to ) best of luck what ever you choose

    Sent from my Moto G (4) using Diabetes.co.uk Forum mobile app
     
  3. catapillar

    catapillar Type 1 · Well-Known Member

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    1)it would be highly unusual for a type 2 diabetics to have an NHS funded pump. So if it's at a stage where you aren't sure what type of diabetes you have it's probably a little early to be thinking about a pump. Type 1 diabetics aren't usually considered for a pump so early in diagnosis as honeymooning makes setting basal rates in a pump and knowing what your insulin to carb ratio is difficult.

    2) it certainly is possible to bolus an unintentional amount when using a pump. I've definitely managed to unintentionally bolus when hypo when on a Medtronic. Apparently I just like pressing buttons when hypo, I feel much safer back on omnipod when the buttons can be not actually on my person 24/7.

    You can set most pumps with maximum levels, so they can have a maximum basal dosage that you can turn it up to and a maximum bolus dosage. A maximum level won't stop you potentially overdosing to cause a hypo, but it will limit the amount of the overdose. No pumps have minimum cut offs, so there's no way to stop under-dosing. I suppose at least the pump would have an infallible record of what has been given so you can follow up with appropriate correction.

    An alternative solution would be to just get a syringe, draw out the correct lantus dose for you and have that set aside so you can only inject the pre-drawn maximum of your lantus dose with no dialling up faff necessary.
     
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  4. Anthony_H

    Anthony_H Type 1 · Member

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  5. Lulu9101112

    Lulu9101112 Type 1 · Well-Known Member

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    It's a personal choice I personally prefer sticking to injections and always have since I was diagnosed
     
  6. saruhbeau

    saruhbeau Type 1 · Well-Known Member

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    If you do have type 1, you could do the exact same thing with the pump. You can set a "max bolus" on the pump so you can't give over x amount of units, however you obviously cant set that any lower than you would for the largest meal/correct you need.

    In a way I think the pump would be LESS safe. Only because if you don't bolus/correct with the pump and go high you will become iller quicker. Same if you accidently suspended your insulin. You have no long acting background insulin in your body and could go into DKA rapidly.

    It is very early days for you and you haven't got a firm diagnosis of which type of diabetes you have yet. I would just do your best and perhaps make sure someone watches you when you do you long acting insulin so you don't miss that.

    I can imagine how your conditions may make you feel less independent, no longer driving etc. I relate in a way as I had severe idiopathic hypersomnia as a teen which thankfully is no where near like it used to be, but it really felt I was sleeping my life away.
     
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  7. azure

    azure Type 1 · Expert

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    I'd worry that wearing a pump would make someone more likely to start pressing buttons when they didn't mean to. Its certainly possible to dial a dose wrongly.

    I'm going to go the opposite way in my suggestion: would two injections a day be easier for you? So one in the morning, supervised if possible, and another in the evening, again supervised. You'd have to eat set amounts of carbs and stick to more of a routine, but with less injections there'd be less occasions for mistakes.

    These injections would be mixed insulin, so two injections would cover you.
     
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  8. Anthony_H

    Anthony_H Type 1 · Member

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    TBH, it wasn't so much the one injection of Lantus that was concerning me but more the novorapid doses which I'm taking currently 4 x daily and already in different doses.
    My blood glucose levels are mid high teens on average with the odd one going high single figures and also low 20's. I appreciate these will continue to drop over the next few weeks but at present my dosages are 24 units lantus once daily with my wife checking the dose and 25 units rapid taken before meals including a small supper one due to a general craving for food between 10pm-midnight. 8,6,8,3. My wife is generally absent for at least two of these and our bedtimes are generally different too so really she's only able to monitor my evening meal dose.

    I get up normally around 4.30 and check my BG and ketones first thing. I then have my medication for my other illnesses but don't eat until around 9am.....just coffee and water in the interim. So first injection and another BG is around 9. I'm snacking nuts and cucumber and trying my best to understand carbs which is all new to me. I'm keeping a good diary for the dietitian and specialist nurse and hopefully we can try to find a solution to my concerns.

    After reading the responses so far I'm not anticipating an easy solution but hopefully a method can be devised which will help my unusual situation.
     
  9. Antje77

    Antje77 LADA · Moderator
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    I go with Catapillar. Predraw syringes. Maybe it's even possible with the novorapid. Something like predrawn syringes with ten or five or whatever units. That way you have to get them from where you store them, put them on the table, count again and then inject. A lot of hassle but it might take enough time for you to get out of one of your sleeplike moments. I wish you all the best with finding a way with this complicated double problem and I hope you find an easier solution than this one.
     
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