Insulin pump advise

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SiobhanR

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Type 1
Hi all,
I’ve been type 1 for 36 years and am currently on humalog and tresiba with the freestyle Libre 2.
I am due to see my diabetic nurse in March as I really want to go on an insulin pump, she has already warned me that criteria bar is set high and I know the main things are no hypo awareness, can’t control diabetes without having hypos or high hba1c readings.
I don’t have very good hypo awareness if it wasn’t for the alarm on the libre going off most times I wouldn’t know until a while after when I start to feel light headed.
Has anyone been granted an insulin pump for other reasons?
I do think my mental health has slightly suffered over the last few years with my diabetes, I do on occasion forget to do my insulin when I eat and then my glucose shots through the roof! And being perimenopausal now isn’t helping!
Any advice would be really appreciate.
Thank you x
 
Hiya @SiobhanR. 🙂

At my first pump clinic appointment, I gave three reasons that I thought made me eligible for a pump. 1. My A1c was stuck at around 8% for ten years on MDI (with Apidra and Tresiba) despite trying everything to lower it. 2. I was struggling with my BG during exercise - Tresiba’s great but there was no dosing flexibility around exercise - to the extent that I’d stopped doing some activities cos it was too much hassle. 3. I clearly needed different basal amounts at different times of day, eg my daily 10 units was spot-on overnight but too much during the day.
In a nutshell, I needed the dosing flexibility a pump can give...and I was given the go-ahead, yippee! 🙂 Been pumping since June last year.

Good luck!
 
Bloden said:
Hiya @SiobhanR. 🙂

At my first pump clinic appointment, I gave three reasons that I thought made me eligible for a pump. 1. My A1c was stuck at around 8% for ten years on MDI (with Apidra and Tresiba) despite trying everything to lower it. 2. I was struggling with my BG during exercise - Tresiba’s great but there was no dosing flexibility around exercise - to the extent that I’d stopped doing some activities cos it was too much hassle. 3. I clearly needed different basal amounts at different times of day, eg my daily 10 units was spot-on overnight but too much during the day.
In a nutshell, I needed the dosing flexibility a pump can give...and I was given the go-ahead, yippee! 🙂 Been pumping since June last year.

Good luck!
Click to expand...
Thanks for the reply, I really appreciate it. I struggle to exercise as I sometimes have crazy swings in my blood, especially if I’ve had a busy day at work. I find it so frustrating I’ll have a day or two of good sugars and do some exercise then it will go whack-a-doodle and I’ll feel drained and can’t exercise. I also feel having dosing flexibility would help, sometimes I can eat something then a few days later eat the same thing do the same amount of insulin for it to go wrong!
I am crossing everything
 
If you drive be careful about using hypo unawareness to get a pump. If you do have hypo unawareness you must declare that to the DVLA and will lose your driving licence. Have you tried running higher to regain the awareness?
 
My justification for a pump was difficulty managing my levels whilst exercising.
I do something like gym, spin or climbing 5 or 6 days a week so it is very important to me.
This was not all about hypos. It was also highs for some types of exercise such as climbing.
Bear in mind you will still need to carb count and bolus with a pump. It will not overcome your problem about eating the same thing and your levels reacting differently.
 
My reasons for the pump was based on the data from my libre 2, which is great if you record all your info on there the medical team can see if you meet the requirements.

Me and my nurse have tried a number of things to improve my levels, the changes in background insulin every other week impacting my sleep and mental health. My hb1ac meets the nice requirements and I have no hypo awareness if I am asleep. Fine in the day.

Look at the nice guidelines, and go with good records on what you have tried. I didn’t have to talk either the nurse or consultant into it, they both looked at my data and said yes instantly.

Good luck
 
My main drivers for getting the pump were to reduce overnight hypos, and to give me more flexibility to exercise. I was also getting frustrated with the limitations of MDI.

The night hypos were difficult even with a split basal of Levemir, and I was waking regular,y to treat these, so also getting very tired. The pump enabled me to adjust the basal hour by hour and these did settle a lot. Exercising in a pump was a lot easier. It gave me the chance to turn my basal insulin down prior to any planned exercise For how ever long I needed to. This depended on the intensity and duration of the exercise.

As @helli said the pump does not remove the requitement to carb count and remember to bolus for meals.

Let us know how you get on. If offered a pump each clinic will support certain pumps so worth asking what is on offer. There will be someone on here using each of them with their tips and plenty of other generic advice.
 
SiobhanR said:
Hi all,
I’ve been type 1 for 36 years and am currently on humalog and tresiba with the freestyle Libre 2.
I am due to see my diabetic nurse in March as I really want to go on an insulin pump, she has already warned me that criteria bar is set high and I know the main things are no hypo awareness, can’t control diabetes without having hypos or high hba1c readings.
I don’t have very good hypo awareness if it wasn’t for the alarm on the libre going off most times I wouldn’t know until a while after when I start to feel light headed.
Has anyone been granted an insulin pump for other reasons?
I do think my mental health has slightly suffered over the last few years with my diabetes, I do on occasion forget to do my insulin when I eat and then my glucose shots through the roof! And being perimenopausal now isn’t helping!
Any advice would be really appreciate.
Thank you x
Click to expand...

Your almost certain to be candidate for pump.

Reason got mine was quality of life, having to inject over 6x day & sites getting overused.
 
Lucyr said:
If you drive be careful about using hypo unawareness to get a pump. If you do have hypo unawareness you must declare that to the DVLA and will lose your driving licence. Have you tried running higher to regain the awareness?
Click to expand...
Hi, I don’t drive. I do try running high every now and then and it does help. X
 
helli said:
My justification for a pump was difficulty managing my levels whilst exercising.
I do something like gym, spin or climbing 5 or 6 days a week so it is very important to me.
This was not all about hypos. It was also highs for some types of exercise such as climbing.
Bear in mind you will still need to carb count and bolus with a pump. It will not overcome your problem about eating the same thing and your levels reacting differently.
Click to expand...
I find sometimes weight training makes my sugar go up rather than down.
I know I’ll still have to carb count. The different reactions to the same food can just be frustrating!
 
PhoebeC said:
My reasons for the pump was based on the data from my libre 2, which is great if you record all your info on there the medical team can see if you meet the requirements.

Me and my nurse have tried a number of things to improve my levels, the changes in background insulin every other week impacting my sleep and mental health. My hb1ac meets the nice requirements and I have no hypo awareness if I am asleep. Fine in the day.

Look at the nice guidelines, and go with good records on what you have tried. I didn’t have to talk either the nurse or consultant into it, they both looked at my data and said yes instantly.

Good luck
Click to expand...
I do log everything on the Libre app. I even put moans about highs and lows in the comment section!
 
SB2015 said:
My main drivers for getting the pump were to reduce overnight hypos, and to give me more flexibility to exercise. I was also getting frustrated with the limitations of MDI.

The night hypos were difficult even with a split basal of Levemir, and I was waking regular,y to treat these, so also getting very tired. The pump enabled me to adjust the basal hour by hour and these did settle a lot. Exercising in a pump was a lot easier. It gave me the chance to turn my basal insulin down prior to any planned exercise For how ever long I needed to. This depended on the intensity and duration of the exercise.

As @helli said the pump does not remove the requitement to carb count and remember to bolus for meals.

Let us know how you get on. If offered a pump each clinic will support certain pumps so worth asking what is on offer. There will be someone on here using each of them with their tips and plenty of other generic advice.
Click to expand...
I have read good things about exercising with a pump vs injections which is my main motivation.

If I had a preference I would say omnipod as there is no tubing.
 
SiobhanR said:
I have read good things about exercising with a pump vs injections which is my main motivation.

If I had a preference I would say omnipod as there is no tubing.
Click to expand...
I have had a tubed pump throughout so cannot compare it to patch pumps. I did try a sample Omnipod and found that I didn’t like having such a big lump stuck to me. I prefer the flat profile of the cannula dn tubing and then being able to put my pump wherever I want to.

As this will be your first pump I think you will happy with whichever one you choose. It really can make life so much more flexible.
 
SB2015 said:
I have had a tubed pump throughout so cannot compare it to patch pumps. I did try a sample Omnipod and found that I didn’t like having such a big lump stuck to me. I prefer the flat profile of the cannula dn tubing and then being able to put my pump wherever I want to.

As this will be your first pump I think you will happy with whichever one you choose. It really can make life so much more flexible.
Click to expand...
Yeah I get what you mean it would be like having an egg attached to your body!
 
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