How long do I have to wait to get a pump?

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JamesJSmall

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Type 1
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Hi,

I’m new to here, had diabetes since I was 17 and I feel like desperate to get a pump. How long did you guys have to wait?
 
It is different for everyone and depends on individual circumstances as to how you may benefit from a pump and whether you fit the guidelines to be eligible for one.

What is it about a pump which you feel will help you and do you know the guidelines and how you might qualify under them.

Have you discussed it at clinic with your DSN or consultant and if so, what do they say?

It isn't just about how long you have been diagnosed and you usually have to make a case for yourself, so finding out how you might qualify is important. Hopefully someone will post a link to the NICE guidelines...
 
Hi Barbara,

Thanks for your reply, currently on waiting list to get back to the diabetic clinic as I missed two appointments - think that’s ludicrous had exams on during the time and forgot but is what it is. Looking forward to making my case and hoping it’s in the pipeline.
 
That is a shame. Clinic appointments are getting further and further apart for many of us as their staff workload is increasing. Covid caused an increase in need for their services and also an increase in diagnoses so referrals to get back into the system are taking time and then the priority at the moment seems to get those people who are already on a pump onto Hybrid Closed Loop.

How long have you been waiting for your referral? Even after your initial appointment and assuming you qualify for a pump under the guidelines, they then have to apply for funding and put you on a list for training so the process can take 6 months to a year from getting approval to be put forward for a pump.

Do you know much about pumping insulin. Doing some research into it and how you feel it will benefit your diabetes management will help, giving examples of the issues you have with your current management, what you have tried to overcome those difficulties and how a pump would solve the problem.

The thing to understand is that they are not just "plug and play" and they need quite a bit of input from the patient to to find settings that work best for you in various real life situations. You can learn a lot from reading posts about them on this forum.
 
Yeah I’ve got an appointment in January to begin the clinic again, assume it’s an initial one.

Read the NICE guidelines and my hba1c is lower than what they recommend, however as a result I’m getting more frequent hypos. Think also as a mental health nurse, working on wards can become a real challenge with t1.

We’ll see what happens, was having one of those moments earlier when you’re looking for a quick fix. Feel better voicing this in a thread. Thanks for your help with this and taking the time to reply to me.
 
Good luck with your appointment in January. Going prepared with a check list of points should help and if they refuse as often happens first time ask for their reasons and then go away and make a case for yourself to refute those points.

Do you adjust your basal doses yourself? Just wondering if your basal dose has been the same for months or years whether some adjustment of that might help with the hypo situation. I find that I have to regularly tweak my basal depending upon activity but I have Levemir which is flexible enough to allow adjustment.

Another thing to consider is what level you have your low alarm/alert set at on your CGM? Most people here on the forum have it set above 4 and some above 5 so that they can prevent hypos before they happen. I have mine set at 4.5 which works pretty well for me but some people have it set at 5 or even the max 5.6 that Libre allows. I think Dexcom allows an even higher low alert.
Having a graded response to those alarm settings are also important, so for instance, I will have 1 jelly baby or a dried apricot if my low alarm goes off at 4.5 with an horizontal arrow unless I know there are carbs in my system still releasing, but 2 jelly babies if I have a 4.5 with a vertical downward arrow. This is what works for me but other people have different responses based on how their body reacts. I tried raising my low alarm higher but ended up having more hypos because I didn't want to treat at 5 which is a good normal level after all and then the alarm wouldn't go off again if I dropped lower and if I got distracted doing something instead of keeping an eye on it I would end up \Libre saying I was below 4...... It usually exaggerates a bit for me though, so I don't worry about the odd excursion into the red too much.

Have you had a DAFNE or equivalent course. Some clinics used to consider it a prerequisite for getting a pump. It is an intensive education course on dose adjustment and diabetes management with insulin. If you haven't had one then that might be something to consider asking about.

Anyway, just some thoughts on things you might consider to help in the mean time.
 
Such a great idea to set it higher, I can’t believe I haven’t thought of that! Had the same long acting insulin since diagnosis but do change it, have 18 units a day but when I excersise I drop it to 16
 
From the time I was diagnosed to the time I got a pump was 12 years.
But remember a pump is just another way of giving you insulin. You still need to carb count and treat hypos and change the pump every 3 days. You just have more “dials to twiddle”. Unless you hybrid closed loop, you can find yourself thinking about diabetes even more as you twiddle the dials.
 
It can really vary from clinic to clinic @JamesJSmall

Partly down to staffing and appointment availability. But different clinics do seem to have a slightly different sequence of events too.

Have you started the conversation with your clinic?
 
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