"artificial pancreas to revolutionise diabetes care in England"

[trophywench]

The BBC News report riled me - showing a little child with a Dexcom sensor and pump, looped. Child liked it because she no longer needs to 'have needles or prick her fingers'. At least her mother said 'since she's had a loop ....' but this was presented as 'new' - well OK it isn't ancient but the new sensor they're trialling is implanted not worn on the outside of the arm ....

 

[Bruce Stephens]

it isn't ancient but the new sensor they're trialling is implanted not worn on the outside of the arm

Is it, though? Or is it just a Dexcom G6 (or maybe their new Dexcom One), which could be said to be "implanted" in the sense that a little bit of it is under the skin? If it's really a different implanted device, how long does it last and how annoying is it to change when it needs changing? (Not sure how well the Eversense is going. Oh, OK, the E3 can last "up to 6 months" which would be decent. Still a bit annoying, but might be worthwhile for small children, though there's still the pump which is presumably external.)

 

[Rob Oldfield]

I've been starting to look into them as I'm so sensitive to the insulin while I'm moving about but as soon I sit down it grinds to almost a halt lol. I've got days where I can be busy all morning and nothing in the afternoon except paperwork. So I adjust my basal down then find I need it back up later. Sadly I'm just under the criteria for one with my hba1c . Having said that I've got a review Monday so who knows lol.

Hi @gillrogers

I was given a pump as my team decided that the fact I was experiencing 'dawn phenomenon' qualified me, while my HbA1c was within the 'good' range. I'd suggest that your insulin sensitivity might put you in the same boat.

Of course, different trusts are going to work in different ways so you're best placed to deal with them, but it might be worth thinking about stressing that your routine can vary and that the different basal profiles available on a pump (where you can modify the ongoing 'background' insulin you're getting) would be useful.

 

[gillrogers]

Hi @gillrogers

I was given a pump as my team decided that the fact I was experiencing 'dawn phenomenon' qualified me, while my HbA1c was within the 'good' range. I'd suggest that your insulin sensitivity might put you in the same boat.

Of course, different trusts are going to work in different ways so you're best placed to deal with them, but it might be worth thinking about stressing that your routine can vary and that the different basal profiles available on a pump (where you can modify the ongoing 'background' insulin you're getting) would be useful.

Thanks @Rob Oldfield , that was going to be the angle I would take. It was what was making me think this might be better for me. It's really starting to impact my job.

 

[SB2015]

Hi @gillrogers I eventually got my pump as I was very sensitive to insulin, so 1/2 unit changes just didn’t match what I needed. I was also finding exercising very difficult to manage and having loads of hypos. I am very pleased I did the switch.

As far as I know the ‘artificial pancreas’ in the news is nothing more than what some are already using such as the Medtronic 780G and T-slim pumps used as a closed loop. I suppose our sensors are ‘implanted’ under the skin in a way in that we fire them in each time in much the same way as the Libre goes in. I don’t think it is anything new, and yes we still need to let the pump know how many carbs we are eating.

I took me some time to get used to the new pump and the time it took the pump to get to know my metabolism but I am very happy with the reduction in hypos and how I need to think a lot less about diabetes each day. There is still the carbs and pre bolus interval to consider, but the rest is done for me.

I have recently had COVID and have been pleased to have the system spot the increased need for basal and get on with any adjustments for me. I had expected to have to switch back to manual but as my symptoms are mild, the pump is coping well, and leaving me to rest and recover. A bit of a difference from being ill on my old pump.

Funding for these closed loops will understandably be limited but if they get down to a smimilar price as Libre then there may be wider access. Who knows what is to come, as things change so much year by year. So this is nothing new and I think it may be the revision to the NICE guidelines that has the press release. I know I have had a lot of conversations about my closed loop system with friends this week!

 

[gillrogers]

Thanks @SB2015 , Thursday I just pushed a few small tables , 2 or 3 around the lounge at the hall , took a tray of cups and saucers into the kitchen and put the hoover round and ended up spending Thursday evening battling to stop a fast approaching hypo an hour after dinner. I'd already reduced my basal that day as I knew I was going to be a little more active as not sat at my desk working as usual. It's definately affecting my work as I'm now scared of how much physical effort I put into it.

 

[SB2015]

Gather your data, @gillrogers ask for a review and match your data to the NICE guidelines for accessing pumps. It may take time to get a pump but it makes life a lot easier, so long as you are happy to put in the work that is needed

 

[gillrogers]

Cheers, I've got a review on Monday so I'll tackle it then.

 

[trophywench]

I read that the new one had the sensor implanted in the thigh via a cut in the skin. Bit like hormone implants for ladies, except they are inserted in your tummy, via a cut.