Insulin pumps

[Lily123]

You can get a new pen prescribed. It’s a safety issue to have them different colours. It may take a conversation with the pharmacy to get the colour you want as they don’t always get a say in which come in their orders.

Regarding the pump. Talk to your team. Here (Oxfordshire) funding for over 12s isn’t guaranteed but the team will work out how to give the best argument for funding and get them for all their teens. The process here is that they have info days 3-4 times a year and you go on that first to see what options there are and which you’re interested in and then at your next clinic say you want it and they put the funding bid in. Don’t wait until your February clinic drop them an email this week and start the process to see if you’re suitable for one and if they can get one funded for you. There are lots of benefits to having a pump but they’re not completely stress free. My kid is on another break and back on injections at the moment as he was fed up of it.

Which pump you choose may depend on if you want to self fund for a dexcom or other CGM to link it to the pump otherwise they all have some pros and cons. Here they’re not offering omnipod to new patients but otherwise have a good variety of options.

In regards in sending an Email to the diabetes team , I will get one of parents to do that (I don’t have the Email) The chances of me getting a pump may be fairly good as they were very happy to fund the Libre. They said about it at the end of May last year and by early July I had my first sensor!

 

[helli]

@Lily123 good luck with the pump.
I think your success with the Libre may be a red herring. i hope not.
But more people have Libre than pumps and, in some areas, Libre have been prescribed instead of pumps to help with Type 1 management.

In your case, your Libre seems to have given evidence for the need for a pump but not everyone may see it that way. If you have a supportive and informed DSN, you should be ok. Unfortunately, not every one is so lucky.

Good luck, keep us informed and feel free to ask questions to help with your research. Quite a few of us have been through the ”justify why a pump would help me” discussions.

 

[Lily123]

@Lily123 good luck with the pump.
I think your success with the Libre may be a red herring. i hope not.
But more people have Libre than pumps and, in some areas, Libre have been prescribed instead of pumps to help with Type 1 management.

In your case, your Libre seems to have given evidence for the need for a pump but not everyone may see it that way. If you have a supportive and informed DSN, you should be ok. Unfortunately, not every one is so lucky.

Good luck, keep us informed and feel free to ask questions to help with your research. Quite a few of us have been through the ”justify why a pump would help me” discussions.

My paediatric team have been supportive and I had never even head of a Libre before they said they would put it on my prescription! I think my main need to get a pump is hypos that can’t be explained (if I adjust the ratio of the meal before that I go high so I think it’s basal but the rest of the time the hypos are down to meal ratio) and that the spikes that can vary from 8 o’clock at night to midnight. As right now my numbers have slowly started to creep up

 

[Inka]

Have you done a recent basal test @Lily123 ? You say your numbers are creeping up. I find my basal needs tweaks through the year and for you as someone who’s still growing, then it could be your basal needs changing as part of that. I can’t remember - what basal are you on?

 

[Lily123]

23.5 Tresiba at night - I only recently adjusted it a few weeks back and it didn’t stop the spikes. I don’t think I would manage to do a basal test because of school and at the weekend and school holidays the routine is thrown out the window

 

[Inka]

My thought would be to consider trying a different basal eg Levemir. It’s an awful lot more flexible because you have two injections a day so can adjust the day bit separately from the night part. Someone here recently stated that Tresiba didn’t work so well for women/girls compared to men due to hormonal fluctuations.

So, I’d trial a twice-daily basal to see if it helps at all. Apart from possibly improving things for you, it could also be useful evidence in your pump search.

 

[Lily123]

My thought would be to consider trying a different basal eg Levemir. It’s an awful lot more flexible because you have two injections a day so can adjust the day bit separately from the night part. Someone here recently stated that Tresiba didn’t work so well for women/girls compared to men due to hormonal fluctuations.

So, I’d trial a twice-daily basal to see if it helps at all. Apart from possibly improving things for you, it could also be useful evidence in your pump search.

I’ll ask about maybe trying a different basal at my next appointment as the Tresiba could be the problem. Up until about September I was using Lantus

 

[Lily123]

I’ve done some research on pumps - thanks for the suggestion to research @Inka . I wasn’t aware quite how many different pumps existed. I think my pump of choice would either be the Tandem T-slim X2. Is it possible to use that pump without the Dexcom? Or the Medtronic 780g. The DANA RS looked like a really good pump but I don’t think I would be able to read the screen very well. I’m getting a tiny bit ahead of myself! I haven’t even asked my diabetes team if I could get funding for a pump yet!

 

[Inka]

I have the DANA RS and it’s fantastic 🙂 You use an app on your phone to control it so I rarely look at the screen - only to prime the cartridge, etc, every few days. When I first got the pump and saw how dinky it was, the rep said “Oh, you won’t ever look at the screen” and I didn’t believe him but it’s absolutely true! The app is brilliant and you can do everything on it - bolus, change your basal, set a temp basal, etc. It’s the most popular pump by far at my clinic.

 

[Lily123]

I have the DANA RS and it’s fantastic 🙂 You use an app on your phone to control it so I rarely look at the screen - only to prime the cartridge, etc, every few days. When I first got the pump and saw how dinky it was, the rep said “Oh, you won’t ever look at the screen” and I didn’t believe him but it’s absolutely true! The app is brilliant and you can do everything on it - bolus, change your basal, set a temp basal, etc. It’s the most popular pump by far at my clinic.

I’m not overly keen on having a pump controlled by my phone - I am just about okay with using my phone for the Libre .I would prefer more old-school of controlling the pump from the actual pump

 

[Pumper_Sue]

I’m getting a tiny bit ahead of myself! I haven’t even asked my diabetes team if I could get funding for a pump yet!

Hi Lily, if you want a pump, write down all the reasons you want one and how you think a pump will help you.
Being one step ahead is always a good start 🙂
At 14 you come across as a very mature young lady who would do very well with a pump, so have my fingers crossed your wish is granted.

 

[Lily123]

Hi Lily, if you want a pump, write down all the reasons you want one and how you think a pump will help you.
Being one step ahead is always a good start 🙂
At 14 you come across as a very mature young lady who would do very well with a pump, so have my fingers crossed your wish is granted.

I might have solved the hypers in the evening issue but maybe not as it is school holidays I don’t have the same knock on effect of 30 minute walk home from school so I will know if the spike is solved in about a fortnight. Thanks for the compliment. I will make a list as that is a really good idea as at the end of the appointment when I’m asked if I have any questions my mind goes blank so writing it down should help

 

[Inka]

I’m not overly keen on having a pump controlled by my phone - I am just about okay with using my phone for the Libre .I would prefer more old-school of controlling the pump from the actual pump

Ah, ok 🙂 Well, you can use the pump itself it you want to. I did for the first week or so because I was used to doing it that way with all my previous pumps. Then I tried the app and gradually switched over to just using that. The DANA screen is small but it mainly has icons - good size icons that you can see easily and which take up most of the screen. The numbers are big enough too.

 

[Lily123]

Ah, ok 🙂 Well, you can use the pump itself it you want to. I did for the first week or so because I was used to doing it that way with all my previous pumps. Then I tried the app and gradually switched over to just using that. The DANA screen is small but it mainly has icons - good size icons that you can see easily and which take up most of the screen. The numbers are big enough too.

I will go back and research that pump again as what you have said has changed my opinion

 

[Lily123]

I have got this as a list so far, but I don’t know if this would meet the guidelines for getting a pump

 

[Inka]

That’s a well thought-out list @Lily123 I’d add a little about why your current regime doesn’t work for doing those things. It was years ago that I got my pump but I did have to explain why no other options worked. So, if you keep that in mind, you’ll be ready to explain what you’ve tried to solve these issues and that it didn’t work.

Have you looked at the NICE criteria? I found they helped focus me too.

 

[Lily123]

That’s a well thought-out list @Lily123 I’d add a little about why your current regime doesn’t work for doing those things. It was years ago that I got my pump but I did have to explain why no other options worked. So, if you keep that in mind, you’ll be ready to explain what you’ve tried to solve these issues and that it didn’t work.

Have you looked at the NICE criteria? I found they helped focus me too.

The NICE criteria is what I’m nervous about as I’ve managed to adjust ratios to avoid most hypos I don’t actually meet any of it with a HbA1C of 53

 

[Inka]

Try focusing on your quality of life. For example, if somebody had technically solved nighttime highs by setting an alarm to bolus at 2am every night, they could claim that having to do that negatively impacted on their quality of life even though it solved the problem. If you can find some actual examples from your life, that would be good eg times when you had to go beyond reasonable to control your blood sugar, times when your education was affected, times when your sleep was disturbed.

 

[Lily123]

Try focusing on your quality of life. For example, if somebody had technically solved nighttime highs by setting an alarm to bolus at 2am every night, they could claim that having to do that negatively impacted on their quality of life even though it solved the problem. If you can find some actual examples from your life, that would be good eg times when you had to go beyond reasonable to control your blood sugar, times when your education was affected, times when your sleep was

I have struggled with having to miss lessons because if I have PE the lesson before I will have to spend time in the medical room because of the hypo that is inevitable. I’ll add to the list. I also find that I spike after every meal because I always inject before eating (I would forget after)

 

[Pumper_Sue]

I have struggled with having to miss lessons because if I have PE the lesson before I will have to spend time in the medical room because of the hypo that is inevitable. I’ll add to the list. I also find that I spike after every meal because I always inject before eating (I would forget after)

These are all very good points esp as they affect your quality of life. Write down all the things you have tried to solve the problems you have.
Many people split their bolus if eating fatty or high protein meals. So a pump would help you do this as well because you can set different boluses to suit your meals.