Clinic, HbA1C and guess who's going to b'mouth pump clinic???

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salmonpuff said:
And fought my corner for the pump, mentioned lifestyle, swinging sugars, the job, hating injections and then I hate to say it, I turned on the tears. I have been referred to the pump clinic in bournemouthBut now I need your help guys, I need to put together a solid case for b'mouth...I don't want to turn up there only to be told no 😱 Step 1 is complete! I have talked my consultant round to it! HURRAH!
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NICE guidelines ( Recommendation 62 ) on CSII are pretty vague and not much help to you really .....

"R62 Continuous subcutaneous insulin infusion (insulin pump therapy) is recommended as an option for people with Type 1 diabetes provided that:
● multiple-dose insulin therapy (including, where appropriate, the use of insulin glargine) has failed;* and
● those receiving the treatment have the commitment and competence to use the therapy effectively."

Depends what they mean by basal/bolus has "failed" or what the star is directing us to. They might be judging everything in terms of HbA1c ( their usual trick) rather than on hypos and wild fluctuations etc or Quality of Life.
 
Peter C said:
NICE guidelines ( Recommendation 62 ) on CSII are pretty vague and not much help to you really .....

"R62 Continuous subcutaneous insulin infusion (insulin pump therapy) is recommended as an option for people with Type 1 diabetes provided that:
● multiple-dose insulin therapy (including, where appropriate, the use of insulin glargine) has failed;* and
● those receiving the treatment have the commitment and competence to use the therapy effectively."

Depends what they mean by basal/bolus has "failed" or what the star is directing us to. They might be judging everything in terms of HbA1c ( their usual trick) rather than on hypos and wild fluctuations etc or Quality of Life.
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thanks for that peter, i think I know what the nice guidelines are and how they will or will not help me 🙄 i'm sorry, but you're not the one dealing with hypos on a daily basis, and there is in fact a part of the nice guidleines that states specifically that 'frequent disabling hypoglycemia' is qualification for pump therapy. And hey, guess what peter? I HAVE THAT. I have lost count of the times when Matt has had to help me out of a hypo, and they are also disabling in the fact that I have chronic fear of doing anything incase I have a hypo.

So please, maybe ASK next time instead of blundering in and quoting the guidelines at me. I have done enough research of my own to know what they are.
 
Hi Peter, I'm not sure how old your information is? The guidelines released in July 2008, which are being used at the moment, state:

"Continuous subcutaneous insulin infusion (CSII or ?insulin pump?) therapy is recommended as a treatment option for adults and children 12 years and older with type 1 diabetes mellitus provided that:

? attempts to achieve target haemoglobin A1c (HbA1c) levels with multiple daily injections (MDIs) result in the person experiencing disabling hypoglycaemia. For the purpose of this guidance, disabling hypoglycaemia is
defined as the repeated and unpredictable occurrence of hypoglycaemia that results in persistent anxiety about recurrence and is associated with a significant adverse effect on quality of life

or

? HbA1c levels have remained high (that is, at 8.5% or above) on MDI therapy (including, if appropriate, the use of longacting insulin analogues) despite a high level of care."

I got my pump on the basis of hypos, despite having an HbA1c of 6.9% when I was being put forward. Problems with hypos and quality of life are definitely reasons for going on a pump! 🙂
 
randomange said:
Hi Peter, I'm not sure how old your information is? The guidelines released in July 2008, which are being used at the moment, state:

"Continuous subcutaneous insulin infusion (CSII or ?insulin pump?) therapy is recommended as a treatment option for adults and children 12 years and older with type 1 diabetes mellitus provided that:

? attempts to achieve target haemoglobin A1c (HbA1c) levels with multiple daily injections (MDIs) result in the person experiencing disabling hypoglycaemia. For the purpose of this guidance, disabling hypoglycaemia is
defined as the repeated and unpredictable occurrence of hypoglycaemia that results in persistent anxiety about recurrence and is associated with a significant adverse effect on quality of life

or

? HbA1c levels have remained high (that is, at 8.5% or above) on MDI therapy (including, if appropriate, the use of longacting insulin analogues) despite a high level of care."

I got my pump on the basis of hypos, despite having an HbA1c of 6.9% when I was being put forward. Problems with hypos and quality of life are definitely reasons for going on a pump! 🙂
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random, i think i love you :D
 
salmonpuff said:
thanks for that peter, i think I know what the nice guidelines are and how they will or will not help me 🙄 i'm sorry, but you're not the one dealing with hypos on a daily basis, and there is in fact a part of the nice guidleines that states specifically that 'frequent disabling hypoglycemia' is qualification for pump therapy. And hey, guess what peter? I HAVE THAT. I have lost count of the times when Matt has had to help me out of a hypo, and they are also disabling in the fact that I have chronic fear of doing anything incase I have a hypo.

So please, maybe ASK next time instead of blundering in and quoting the guidelines at me. I have done enough research of my own to know what they are.
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You beat me to it! 😛:D I was in the exact same scenario, so keep fighting and you'll get there! You're already on the way. 🙂
 
randomange said:
You beat me to it! I was in the exact same scenario, so keep fighting and you'll get there! You're already on the way. 🙂
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:D too right :D three today nasty ones they were too...ended up walking home on one which was a rather stupid idea. I knew I shouldn't have done it, and I was really scared but I did it anyway. Stupid hypobrain :(

I'm hoping b'mouth will be more sympathetic than my team were!
 
randomange said:
Hi Peter, I'm not sure how old your information is? The guidelines released in July 2008, which are being used at the moment, state:

"Continuous subcutaneous insulin infusion (CSII or ?insulin pump?) therapy is recommended as a treatment option for adults and children 12 years and older with type 1 diabetes mellitus provided that:

? attempts to achieve target haemoglobin A1c (HbA1c) levels with multiple daily injections (MDIs) result in the person experiencing disabling hypoglycaemia. For the purpose of this guidance, disabling hypoglycaemia is
defined as the repeated and unpredictable occurrence of hypoglycaemia that results in persistent anxiety about recurrence and is associated with a significant adverse effect on quality of life

or

? HbA1c levels have remained high (that is, at 8.5% or above) on MDI therapy (including, if appropriate, the use of longacting insulin analogues) despite a high level of care."

I got my pump on the basis of hypos, despite having an HbA1c of 6.9% when I was being put forward. Problems with hypos and quality of life are definitely reasons for going on a pump! 🙂
Click to expand...

Tx for that Random. I just remembered Salmonpuff saying she was putting a case for a pump together and checked on the NICE guidelines on another site I usually refer to. Thought they might be of use to her. The latest guidelines seem sharper.
 
sam ...im about half way thro ....i ve been just taking threads at mo ( ive got 40 pages !!! ) but they need tidying up a bit...
 
great news Sam I hope you go all the way and get a pink one like Tom's😛
 
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