Insulin pumps

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sg295 said:
Ok great, thank you!

I’m not sure I meet the NICE guidelines that’s the issue but I do have a list of about 13 reasons why a pump could benefit me!

Guess I’d just have to present my list and hope for the best!
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If you put into the search bar “NICE guidelines for insulin pumps” it should take you too the NICE website and it will tell you the exact guidelines
 
Lily123 said:
If you put into the search bar “NICE guidelines for insulin pumps” it should take you too the NICE website and it will tell you the exact guidelines
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Ok brilliant, thanks for your help!
 
@sg295 i think you mentioned you are new to diabetes - welcome to the club.

As I mentioned above, I really like my pump.
BUT it can go wrong. It never goes wrong at a convenient time. Whilst it is rare, it is stressful and I have to be ready to manage it at any time.
Therefore, I was really glad I injected for so long that it is still second nature to me when I need it.
Unless you have a strong reason for pumping (e.g young children need smaller doses than possible when injecting), I recommend sticking with injections for a year or two so you do not panic when your pump fails and not jumping into pumping straight away.
 
I agree with @helli and I’d also stress again that pumping is just another insulin delivery system. It can be a pain in the bottom like injections, and it’s most definitely not a magic answer. It’s still possible to get poor results with a pump because it depends on its user’s knowledge and experience. Unless you loop, it’s not automatic and you need to be pretty involved with managing it, as well as confident in how to deal with problems. Pump users run a higher risk of DKA.
 
helli said:
@sg295 i think you mentioned you are new to diabetes - welcome to the club.

As I mentioned above, I really like my pump.
BUT it can go wrong. It never goes wrong at a convenient time. Whilst it is rare, it is stressful and I have to be ready to manage it at any time.
Therefore, I was really glad I injected for so long that it is still second nature to me when I need it.
Unless you have a strong reason for pumping (e.g young children need smaller doses than possible when injecting), I recommend sticking with injections for a year or two so you do not panic when your pump fails and not jumping into pumping straight away.
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@helli incase the pump fails (If i get one) would I just need to carry round an insulin pen and needles in my school bag like I do now?
 
helli said:
Therefore, I was really glad I injected for so long that it is still second nature to me when I need it.
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I worry about that kind of thing too (I don't use a pump). I felt lost when I was without Libre sensors for a week or two even though I had test strips (and once upon a time survived with just the useless urine test tape).

That'll be even worse when closed loops become much more common (which they absolutely should and I'd really like one). (I don't have a solution. It's just something that needs some consideration.)
 
Lily123 said:
@helli incase the pump fails (If i get one) would I just need to carry round an insulin pen and needles in my school bag like I do now?
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There are a few options
- typically, the problem is something like an occlusion (blockage) so you just need to change the cannula.
- if I am out for a few hours, I carry a syringe which I can fill from my pump. This is smaller and easier to carry than pens and doesn’t require me to take a pen cartridge out of the fridge and them throw it away unused a few weeks later.
- if I go away overnight, I take my pens for backup.
 
Lily123 said:
@helli incase the pump fails (If i get one) would I just need to carry round an insulin pen and needles in my school bag like I do now?
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I’ve never had a pump fail. What usually happens is some issue with the cannula eg an occlusion alert, or an obvious sign that your site isn’t working (high blood sugar). The pumps have a variety of alerts and alarms.

So, in the above instance, I’d replace my cannula. Remember the pump provides both basal and bolus, and because there is no long-acting insulin blood sugar can rise quickly. If you were to inject basal from a pen, you’d mess up the pump profile and could potentially be at risk of hypos later.
 
helli said:
There are a few options
- typically, the problem is something like an occlusion (blockage) so you just need to change the cannula.
- if I am out for a few hours, I carry a syringe which I can fill from my pump. This is smaller and easier to carry than pens and doesn’t require me to take a pen cartridge out of the fridge and them throw it away unused a few weeks later.
- if I go away overnight, I take my pens for backup.
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I think I would prefer to carry a pen as it is more normal to me rather than carrying a syringe that I would need to fill from the pump. I think It would be a waste of the cartridge in the pen but (if I get a pump) during the first few weeks I would most likely get a few cannulas fail anyway
 
Lily123 said:
I think I would prefer to carry a pen as it is more normal to me rather than carrying a syringe that I would need to fill from the pump. I think It would be a waste of the cartridge in the pen but (if I get a pump) during the first few weeks I would most likely get a few cannulas fail anyway
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Not necessarily 🙂 I don’t remember having any cannula issues early on. They’ve all occurred over time. It’s not usually the user’s fault, just a ‘bad’ site - ie one that doesn’t work properly. The sets and cannulas are the absolute weak point of pumps as it’s them that usually cause problems. I really wish there was a way to sort that problem!
 
Lily123 said:
I think I would prefer to carry a pen as it is more normal to me rather than carrying a syringe that I would need to fill from the pump. I think It would be a waste of the cartridge in the pen but (if I get a pump) during the first few weeks I would most likely get a few cannulas fail anyway
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Cannula fails are rare. I think I experienced one such failure in 4 years with my tubey pump.
If you get one, it better to change your cannula rather than starting pens as you will need basal so will have to start Tresiba in the middle of the day and be aware of Tresiba for the next 3 days when you restart the pump.

This is one of the many things you need to manage with a pump. As i said, it is not easy. But worth it.
 
Inka said:
Not necessarily 🙂 I don’t remember having any cannula issues early on. They’ve all occurred over time. It’s not usually the user’s fault, just a ‘bad’ site - ie one that doesn’t work properly. The sets and cannulas are the absolute weak point of pumps as it’s them that usually cause problems. I really wish there was a way to sort that problem!
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So I would just need to carry a spear cannula? It turns out my parents asked the diabetes team about insulin pumps when I was recently diagnosed and the team said no because I had too good control over my numbers
 
Lily123 said:
So I would just need to carry a spear cannula? It turns out my parents asked the diabetes team about insulin pumps when I was recently diagnosed and the team said no because I had too good control over my numbers
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Yes, I carry a couple of spare sets and cannulas. They come in sterile packs around the size of a pack of playing cards but thinner. I slip one or two in my bag. If I’m away, I also put a spare battery in too.
 
The libre seems to tell more about my control than my HbA1C. This is what my basal did this morning
D4833748-1178-4A38-AD1F-A051E545484A.png
 
The Libre graphs might be useful in your pump quest @Lily123 You can use them as evidence of what you’re describing.
 
Inka said:
The Libre graphs might be useful in your pump quest @Lily123 You can use them as evidence of what you’re describing.
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You’re right the Libre graphs might be helpful. Although the basal would have caused my numbers to slowly drop overnight as I didn’t do a correction that would still be influencing my numbers that many hours on
 
Inka said:
Yes, I carry a couple of spare sets and cannulas. They come in sterile packs around the size of a pack of playing cards but thinner. I slip one or two in my bag. If I’m away, I also put a spare battery in too.
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The cannulas for my pump come in huge blister packs. Very hard to carry in a handbag. If I am only going somewhere I can get home easily I don't carry one. However going on holiday they fill my cabin baggage (with al the other diabetic trankenalia I carry on holiday). When I worked I kept a spare in the office. They are normally inserted with an applicator, but I have done it by hand before. TBH I have only had 1 cannula failure when away from home locally and I just went home and changed it. It's a moot point anyway as they are no longer offering the Combo. In total I think I have only had 2 in 8 years fail.
 
Pattidevans said:
The cannulas for my pump come in huge blister packs. Very hard to carry in a handbag. If I am only going somewhere I can get home easily I don't carry one. However going on holiday they fill my cabin baggage (with al the other diabetic trankenalia I carry on holiday). When I worked I kept a spare in the office. They are normally inserted with an applicator, but I have done it by hand before. TBH I have only had 1 cannula failure when away from home locally and I just went home and changed it. It's a moot point anyway as they are no longer offering the Combo. In total I think I have only had 2 in 8 years fail.
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This is making me gain so much confidence in pumps! I might get told no by the diabetes team tho. Only having 2 cannulas in 8 years fail seems to be that they don’t occur that often.I’d have to carry a spare cannula with me because school is a 30 minute walk from home
 
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