Excited...first step to pump

[Tdm]

Just got my invite to the hcl online pump training after my new consultant said she considers i meet the criteria (yes!)

I know its just joining the queue but i'm excited!

 

[SB2015]

Just got my invite to the hcl online pump training after my new consultant said she considers i meet the criteria (yes!)

I know its just joining the queue but i'm excited!

Understandably excited. Another step along the way

 

[Tdm]

Indeed. All we need now is hcl / cgm for t2 on insulin ...consultant gave me the idea that this could be possible once the capacity issue is sorted. She name dropped partha so, perhaps....

 

[helli]

All we need now is hcl / cgm for t2 on insulin

I agree people with type 2 are unnecessarily treated as second class citizens and they should be entitled to the same tech as Type 1.
However, that is not all we need.
I had my annual review yesterday. I was told my HbA1C suggests I am having too many hypos.
Two minutes later, I was told because my HbA1C is too good for me to be entitled to HCL.
In other words, because of the mental effort I chose to put into managing my diabetes, I am not entitled to treatment to reduce that mental effort.
HCL is needed for everyone who wants it who manage their diabetes with insulin not just those who are struggling.

 

[Tdm]

Yes. Totally agree. You situation is very much how i was with my first consultant said.
Luckily, those on daphe (inc me) got moved over to a new consultant who seems keen to 'interpret' the rules/make a case on other grounds
Mind you, bet i'll be some way down the priority list.
Wonder if you may have more luck with someone more 'pump positive'?

 

[mashedupmatt]

I agree people with type 2 are unnecessarily treated as second class citizens and they should be entitled to the same tech as Type 1.
However, that is not all we need.
I had my annual review yesterday. I was told my HbA1C suggests I am having too many hypos.
Two minutes later, I was told because my HbA1C is too good for me to be entitled to HCL.
In other words, because of the mental effort I chose to put into managing my diabetes, I am not entitled to treatment to reduce that mental effort.
HCL is needed for everyone who wants it who manage their diabetes with insulin not just those who are struggling.

I feel exactly the same and totally agree with you @helli - I've also been told exactly that - and 100% it seems as if you make so much effort into managing the condition so that you are doing well, then you are penalised (regardless of the mental strain) - it's all very frustrating

 

[Tdm]

Plus, some may be inclined to ease off so they can get a pump....

 

[nonethewiser]

Great news, welcome to hcl club.

 

[Ivostas66]

I agree people with type 2 are unnecessarily treated as second class citizens and they should be entitled to the same tech as Type 1.
However, that is not all we need.
I had my annual review yesterday. I was told my HbA1C suggests I am having too many hypos.
Two minutes later, I was told because my HbA1C is too good for me to be entitled to HCL.
In other words, because of the mental effort I chose to put into managing my diabetes, I am not entitled to treatment to reduce that mental effort.
HCL is needed for everyone who wants it who manage their diabetes with insulin not just those who are struggli

I think it has a lot more to do with your healthcare provider. My consultant pushed very hard for me to have the Libre shortly after I was diagnosed due to my job (teacher) and having a 1 year old daughter at the time. He argued with my doctor about the importance of mental health, impact on lifestyle etc and eventually my doctor succumbed. Same thing happened earlier this year with my pump. My time in range and HBA1C were too good to fit the criteria for a pump, but again he and my DSN fought hard for me to have one. Pump in March and closed loop since early November.

Where we live there are 1800 people they need to move onto the system and have been given a 4 year deadline. At the orientation session they weren't too sure how they would meet that deadline, but it was clear most were there as this would significantly improve their mental health, a couple because other conditions were proving challenging to control alongside Type 1 and one who argued it was very much a work related decision (MOD).

 

[Lucyr]

All we need now is hcl / cgm for t2 on insulin

And for the rest of the type 1s? Can’t imagine I’d ever meet the criteria.

 

[mashedupmatt]

And for the rest of the type 1s? Can’t imagine I’d ever meet the criteria.

Same here 🙂

 

[Tdm]

I was assuming it would go to all t1 very shortly.

 

[helli]

I was assuming it would go to all t1 very shortly.

Sadly, i do not share your optimism. It seems to be the good ole postcode lottery. In some areas, you seem to be able to argue that your job/home situation justifies it whereas in my area 8 am just a hba1c number.
The other thing to remember is that it may not be suitable/ wanted by everyone with Type 1*. Some people hate the idea of being attached to something. Some people react to the cannula. Some people do not find the CGM accurate enough. Some people do not want/need to change from what has worked for them for decades.

* As a small aside, I have Type 1. I am not a Type 1. The latter feels like a label for which I maybe judged. I appreciate I maybe in a small group who think so much about language (e.g. I also manage my diabetes, I do not control it) but it helps with the way I consider my relationship with diabetes and, hence, manage it.

 

[Lucyr]

I was assuming it would go to all t1 very shortly.

I believed these to be the target criteria for the 5 year rollout target - mainly hba1c above 58, and then because that’s a nice recommended target it wouldn’t be everyone with hba1c above that that would qualify it would vary by area.

 

[Bruce Stephens]

I was assuming it would go to all t1 very shortly.

I'm guessing it'll start 2026. I think NICE are due to look at how the rollout is going (including evidence from any trials that have been done) and are expected to change the guidance to open it up. I think that's 2026 (maybe 2025?). I'd expect things'll start happening then, with teams gradually extending the offer as they're able to people they know can benefit most. I'm not expecting a rapid rollout to everyone. This is a lot more complex than CGMs and it'll surely take time.

 

[rebrascora]

I wonder if some people who currently have really good TIR and HbA1c will find their results are not quite so good on HCL and if so, whether that might make them feel slightly disgruntled with it.
So say, if you currently have an HbA1c of 43 and you end up with 50 on HCL, how would you feel about that? Is it worth that trade off for less mental effort?

 

[rebrascora]

Oh and by the way, @Tdm delighted for you, since it is clearly what you would like! Sorry, I should of course, have said that first! 🙄

 

[Tdm]

I'm guessing it'll start 2026. I think NICE are due to look at how the rollout is going (including evidence from any trials that have been done) and are expected to change the guidance to open it up. I think that's 2026 (maybe 2025?). I'd expect things'll start happening then, with teams gradually extending the offer as they're able to people they know can benefit most. I'm not expecting a rapid rollout to everyone. This is a lot more complex than CGMs and it'll surely take time.

I think it will turn into one long waiting list for all those with a t1 diagnosis

 

[Bruce Stephens]

I wonder if some people who currently have really good TIR and HbA1c will find their results are not quite so good on HCL and if so, whether that might make them feel slightly disgruntled with it.

I'd be surprised if that didn't happen, occasionally.

 

[Bruce Stephens]

I think it will turn into one long waiting list for all those with a t1 diagnosis

I'm not sure. I'd expect teams to still try and prioritise, just because the constraint will be them (how many people they can offer support to). I guess eventually it'll just become a waiting list. Maybe sooner than I expect.