How can I get a pump?

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Lemonade

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Type 1
I'm not sure entirely how this forum works so I'm not sure if this is being posted in the right place but I would LOVE a pump but am told I'm not suitable for one because my control is too good and I've asked at least 5 times :/

The thing is, my control is only good because I take my sugars up to 8 times a day otherwise it would fall apart. And I'm not really willing to let my sugars go out of control just to get my HB!C to be high enough (though it's so tempting!) The thing is, I think a pump would mean that I would have better control and I do alot of exercise so I do go low quite a lot! Especially during my excercise which is really disruptive (and kinda counter-productive) to the session.

Any advice?

(I should probably say I'm a student so fairly young but over 18 so technically an adult)
 
Lemonade said:
I'm not sure entirely how this forum works so I'm not sure if this is being posted in the right place but I would LOVE a pump but am told I'm not suitable for one because my control is too good and I've asked at least 5 times :/

The thing is, my control is only good because I take my sugars up to 8 times a day otherwise it would fall apart. And I'm not really willing to let my sugars go out of control just to get my HB!C to be high enough (though it's so tempting!) The thing is, I think a pump would mean that I would have better control and I do alot of exercise so I do go low quite a lot! Especially during my excercise which is really disruptive (and kinda counter-productive) to the session.

Any advice?

(I should probably say I'm a student so fairly young but over 18 so technically an adult)
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Hi Lemonade,welcome to the forum. 🙂
There's no reason for you not to have a pump, your lows are affecting your quality of life 🙂
Do read the NICE guidelines and point out that good control is not mandantory for a pump.
Write down all that you think a pump will help you with and your aims when you have the pump.
How do they judge good control, A1c? If your clinic is not pump friendly then ask your GP for a referal to a pump friendly clinic.
 
Hi Lemonade

Welcome to the forum. I split your post off to it's own thread just to make sure that replies to your question didn't get muddled with the other thread 🙂
 
Here's the key bit from the NICE guidelines:

Continuous subcutaneous insulin infusion or ‘insulin pump' therapy is recommended as a possible treatment for adults and children 12 years and over with type 1 diabetes mellitus if:
  • attempts to reach target haemoglobin A1c (HbA1c) levels with multiple daily injections result in the person having ‘disabling hypoglycaemia', or
  • HbA1c levels have remained high (8.5% or above) with multiple daily injections (including using long-acting insulin analogues if appropriate) despite the person and/or their carer carefully trying to manage their diabetes.

Insulin pump therapy is recommended as a possible treatment for children under 12 years with type 1 diabetes mellitus if treatment with multiple daily injections is not practical or is not considered appropriate. Children who use insulin pump therapy should have a trial of multiple daily injections when they are between the age of 12 and 18 years.

‘Disabling hypoglycaemia' is when hypoglycaemic episodes occur frequently or without warning so that the person is constantly anxious about another episode occurring, which has a negative impact on their quality of life.
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Taken from here: http://www.nice.org.uk/TA151 - I've added the bits in bold.

So essentially if the only way you are able to keep your A1c down below 8.5 is to have too many hypos such that you have (or risk) reducing or losing your warning signs and also such that you worry about them happening then it can be argued that you qualify for a pump.

The annoying thing is that (of course) all this is subjective. A pro-pump clinic might have a conversation with you and suggest a pump as a way tackling the challenges you face while another not-so-pump-friendly) clinic would simply see that your A1c is below 8.5 and that you weren't in A&E every other week and that would be that. Additionally depending on your area and/or clinic there may only be so many dished out in a year and your case may have to be reviewed/weighed against others who may benefit from pumping.

I was approved for pump therapy with an A1c in the 6's because of my pretty much constant worry about hypos on MDI. I'd gone some way towards reducing the number with a lot of effort but in simple terms they have fallen by over 50% on a pump *and* those below 3 have fallen by 75%.

The pump is not a 'magic bullet' and not automatic either. Your testing at 8ish times a day would still be key to success on pump therapy IMO. What it does give you though is far more precision and better options for insulin delivery, and the ability to get your basal insulin to do its job properly rather than the 'least worst' version that most people have to live with on injections.

INPUT http://www.input.me.uk can offer help in getting approval for pump therapy.

Good luck with your attempts at getting funding 🙂
 
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Pumps

Hi Lemonade,
Welcome to the forum🙂
Initially I wasn't offered the pump as they thought I would not cope with it all. My hb1ac was 10.1 and I suffered with very high levels and then very low levels.
I firstly enrolled on the Dafne course and started carb counting and then my specialist decided it would be the best option for me.
My hb1ac is now 7.9 and I'm trying to get it down further.
Have you tried speaking to your specialist about going on the pump??
Natb xx
 
Hi guys! Thanks for the help and advice I will let you know how it goes. I have an appointment soon so I will ask again for one and bring up all the new points. I really hope they'll let me have it or at least give me more constructive advice on how to reach better control in the mean time.
^Nat, well done on getting your HB1C down!! That's really good. How long have you had diabetes for?
 
Good luck with your appointment Lemonade, I'll be rooting for you! I'm trying to get one at the moment too but my HBA1c isn't quite at 8.5% level yet.

Let us know how you get on! And don't take no for an answer!
 
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