Getting a pump

[Sambradley5]

Evening all,

Iv been a T1 diabetic for over three years now. Got diagnosed at the age of 20. I heard about the Medtronic pump and the Guardian sensor and I really want to have the switch over from pens to pump. I can control my level’s correctly with my lantus/ nova pens but I want to make my life more easier and reading about the benefits of a pump and a connected sensor which communicates with the pump is really something want. I know the NHS in my area provide this but I want to know how hard it is to apply and be approved for this.

Any reply is appreciated

Sam

 

[Inka]

Here are the NICE guidelines @Sambradley5

1.1 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% [69 mmol/mol] or above) on MDI therapy (including, if appropriate, the use of long-acting insulin analogues) despite a high level of care.

You could start by having an initial chat with your hospital team and see what they say. That would give you an idea. Remember that most Type 1s don’t have a pump, and most of those don’t loop with their pumps. Often a pump will be funded but not the sensor needed to loop. Things have improved though so it’s worth asking some initial questions of your team. There can also be some variation between areas and between hospitals.

 

[helli]

@Sambradley5 are you struggling with your diabetes management in a way that you believe a closed loop pump would help?
These systems are expensive, which is why they are not common. Therefore, you need to consider the value you would get from it and why your clinic should invest in you rather than someone else. Sad as it is, there is not enough money around for all.of us to benefit from the latest tech.
The other thing to consider is that technology can fail. It is rare but, if it does happen, it will never be at a convenient time. Therefore, it is also important that you can show your clinic that you will be able to cope with a failure. This is extra important with a pump because you have no background basal without the pump so levels can rise quickly.
I have had a pump for the last 7 years and it has really helped my diabetes management. Recently, I had to revert back to MDI and remembered how frustrating it is for my lifestyle.
I do not have closed loop. I consider it nice to have but I manage well without.

If you are able to convince your clinic you should get a pump, do not set your heart on any specific pump until you have spoken to them. Different clinics offer different pumps. And you may need to consider self funding the CGM if you want closed loop

Good luck with your conversations with your clinic

 

[SB2015]

Good morning @Sambradley5 from a person looping with the Medtronic pump and sensor. As others have said this system is not readily available so I self fund my sensors. This enables me to use the Medtronic pump I have from the NHS in a closed loop system. For me it is worth it, as it has made my life a lot easier.

I had already been on a pump for 8 years when I switched to this, so I was used to using one. This is important as there are times when I get slipped out of the automated system, and like @helli i have also had the pump die on me (inevitably whilst away on holiday - my own fault I drowned it) so had to switch back to pens.

When I first wanted a pump I was initially refused, so I asked for the reasons. I then gathered data to address each of their points and 6 months later was given the okay. You have already been given the criteria and it is in that basis that the choices are made by each team.

If you are able to get a pump, your area will offer a limited choice of pumps, chosen based on the training/support that they are able to provide. A conversation with your team is a good starting point.

 

[Pumper_Sue]

I want to make my life more easier and reading about the benefits of a pump and a connected sensor which communicates with the pump is really something want.

Having a pump involves a lot of hard work and input from you so it isn't all roses 🙂

 

[everydayupsanddowns]

My understanding is that the most compelling evidence for insulin pump therapy covers reduction in hypoglycaemia.

So if your day-to-day diabetes management involves lots of workarounds and precautions to guard against hypos you can talk to your consultant / clinic about how you need these because your experience of hypoglycaemia has shown you that it is unpredictable, worrying, and plays on your mind constantly.

It then really depends upon whether your clinic is receptive and generally pro-pump.

Good luck!