Closed loop system

Status
Not open for further replies.
nonethewiser said:
Have to disagree there, maybe it is for some but not for everyone.
Click to expand...
I wouldn't say it has a harder but I would say it is more work. The finer control and variable basal provides the tools to get better results. However, unless you do the same thing every day and eat tue same thing every day, you need the do a lot of tweaking to achieve it
 
helli said:
I wouldn't say it has a harder but I would say it is more work. The finer control and variable basal provides the tools to get better results. However, unless you do the same thing every day and eat tue same thing every day, you need the do a lot of tweaking to achieve it
Click to expand...

But these pump tweaks ain't daily helli, most days on mdi involved about 6 bolus injection & 1 basal dose, sometimes more injections to deal with difficult meals, so for me that was more time consuming plus mentally draining than pumping ever has..

Only speaking from personal experience of course but I could never say that pumping is harder work compared to injections.
 
nonethewiser said:
But these pump tweaks ain't daily helli, most days on mdi involved about 6 bolus injection & 1 basal dose, sometimes more injections to deal with difficult meals, so for me that was more time consuming plus mentally draining than pumping ever has..

Only speaking from personal experience of course but I could never say that pumping is harder work compared to injections.
Click to expand...
As long s often said, we are all different.
Take Dawn Phenomenon, fo r example.
The great thing about a pump is you can adjust your basal to cater for it
For me, my DP varies daily depending upon the exercise I did the last 48 hours. So I do need to tweak it daily
 
nonethewiser said:
Have to disagree there, maybe it is for some but not for everyone.
Click to expand...
Yeah, I find pumping easier than MDI too. And my TIR has improved enormously. I struggled to get to 60% with pens but achieve 80% no problem now.
 
Tom1982 said:
Ah I see. So is there a reason people stay on pens?
Click to expand...
Cos they don't qualify. I think if your a1c is higher than 7 you can be offered one (though criteria seen to change as often as the PM these days) bit of a perverse incentive to anyone who wants a pump not to try too hard...
 
Tdm said:
Cos they don't qualify. I think if your a1c is higher than 7 you can be offered one (though criteria seen to change as often as the PM these days) bit of a perverse incentive to anyone who wants a pump not to try too hard...
Click to expand...
I think the guidance is a HbA1C of over 8.5% (69 in new numbers)

For children under 12 the guidelines are a lot better in getting pumps to those who meed them - or that’s what it seems from the guidance
 
Tdm said:
Cos they don't qualify. I think if your a1c is higher than 7 you can be offered one (though criteria seen to change as often as the PM these days) bit of a perverse incentive to anyone who wants a pump not to try too hard...
Click to expand...
Don’t qualify? There’s that word again! How much money could it possibly be!?
 
Tom1982 said:
Don’t qualify? There’s that word again! How much money could it possibly be!?
Click to expand...
The NHS is ridiculously underfunded

This is the most recent guidance from NICE:

620AF196-8EDF-49FC-89BB-A4A8D6543B4E.png
 
Tdm said:
Cos they don't qualify. I think if your a1c is higher than 7 you can be offered one (though criteria seen to change as often as the PM these days) bit of a perverse incentive to anyone who wants a pump not to try too hard...
Click to expand...

Not all about a1c, if condition affects your quality of life or you have frequent hypos despite attempts to reduce them then they all qualify, it says all in NICE guidelines.
 
nonethewiser said:
Not all about a1c, if condition affects your quality of life or you have frequent hypos despite attempts to reduce them then they all qualify, it says all in NICE guidelines.
Click to expand...
Yes, but it still seems quite plausible that most of us don't qualify. Especially with CGMs now being generally available.

(I think the criteria are in need of a bit of an update, but mostly I'm hoping for cheaper systems making it possible to offer looping systems more widely.)
 
Bruce Stephens said:
Yes, but it still seems quite plausible that most of us don't qualify. Especially with CGMs now being generally available.

(I think the criteria are in need of a bit of an update, but mostly I'm hoping for cheaper systems making it possible to offer looping systems more widely.)
Click to expand...

Helps also if you have consultant that is pro pumps.
 
Bruce Stephens said:
Yes, but it still seems quite plausible that most of us don't qualify. Especially with CGMs now being generally available.

(I think the criteria are in need of a bit of an update, but mostly I'm hoping for cheaper systems making it possible to offer looping systems more widely.)
Click to expand...
The thing is, you could self fund a pump if it were a one off payment, but there are all the bits...
But they need to factor in the costs of benefits, treating complications etc
Perhaps when pumps become cheaper and better they'll be more available..
Plus they do have downsides..
Re 'affect quality of life' - well, thats pretty much all of us, to be honest, to some degree
 
Tom1982 said:
Don’t qualify? There’s that word again! How much money could it possibly be!?
Click to expand...
I have to insure my pump. It is insured for £4000. On top of that is the cost of the consumables that need to be replaced every 3 days. i understand this works out significantly more expensive than the pump over the life of the pump (about 4 years). In addition, is the cost of training of patients and staff in every single pump the clinic supports which is why many clinics only support a very small subset of reliable but older pumps. No pumps approved by the NHS are kak but the ones supported my your (or my) clinic may not have all the bells and whistles. Clinics have a budget and chose how to spend it. Some may chose to fund more patients with an older pump whereas some may chose to fund less pumps with full closed loop up to the minute technology.

Compared to the cost of MDI, pumping is very expensive.
 
Last edited:
Tom1982 said:
That’s great. It really seems like the way to go, What exactly is the function of the Basal dose? Is it to keep you ticking over at an in range level? Or are there additional purposes?
Click to expand...
Whether on a pump or injections we need two lots of insulin.
Basal is dealing with the glucose that our body is constantly releasing to keep our bidies ticking over whether we eat or not. On MDI this is given once or twice a day as a slow release insulin. Insulin is covered in stuff that gradually breaks down and releases the insulin over the day.
On a pump thus is replaced with quick acting insulin but it is trickled out throughout the day in tiny amounts, more like what a working pancreas does. With the pump the rate can be adjusted hour by hour to more closely match our individual needs.
Not exactly a technical answer!!
 
Status
Not open for further replies.
Back
Top