Pump / CGM update and questions

[Monkey]

So, I saw the pump team this morning. Had no idea who I was seeing, helpfully, but it was very interesting and really helpful.

(In short, T1 for 20yrs, have a nearly 3yr old and am 8w pregnant with number 2. My consultant at the end of my first pregnancy was keen to discuss pumps in the event of a 2nd pregnancy, so as part of my pre-conception care this appointment was arranged. In the meantime, we got the go ahead to start trying and ended up pregnant!)

Lots of questions, loads of people there (consultant, the pump DSN and two other people who I didn't manage to get the names or jobs of, but I suspect one was a dietician). They agreed that altho my overall control is pretty good (6.7% last hba1c) there's definitely merit in exploring the pump avenue, particularly given pregnancy and breastfeeding. The consultant wants to make a decision quickly (good) so I've been put on the list for a CGM to get a better overall picture, and we'll make a decision based on that.

They did agree that mornings are a particular issue, regardless of pregnancy - at the moment I'm needing to inject and eat breakfast (fine) then eat a couple of huge snacks thro the morning to stop late morning hypos. Fine at the moment (eating stops pregnancy nausea for me!) but I don't really want to keep eating like that for the next 7 months, which they were wholeheartedly in agreement with. They also agreed with my concern that despite good control last time (hba1cs in 6-6.5%), C was still massive (10lb 11oz at 38w) and anything we could do to avoid that this time would be a bonus.

Apparently as an antenatal patient I'll be put above other folk (I feel irrationally guilty about this...) so the CGM could be as soon as next week. 😱 Questions - how long is a CGM generally for, when it's to collect data like this? Apparently it'll be one where I can see the readings as they're happening, as they felt that'd be far more useful to me than getting the results later.

They've given me all the info on the pumps they use (Accu Chek Combo, Animas Vibe/2020 and Parasigm Veo) so I may well canvas opinions if that's the route we go down.

All in all, very positive.

 

[Northerner]

Sounds really good Monkey 🙂 Can't answer your questions, but wish you all the best! Don't feel guilty, your circumstances ought to be taken into consideration so it's good to see that they are and you're not being made to wait through such an important period 🙂

 

[everydayupsanddowns]

Sounds like a great appointment!

From what I've heard (no necessarily pregnancy related) loan-CGMs seem to be issued for around 6 days - 1 week (ie 1x sensor). Might be different for you though.

 

[Ellie Jones]

Couldn't say how long they loan a CGM has never had one!

Personally, when they come up with 'we need a CGM, to determine if you need a pump' the going for stalling tactics...

Even though a CGM is good at picking up patterns, so helpful to see where perhaps adjustments might be made, the information it picks up now as you'll pregnant will be totally irrelevant in a couple of weeks time! So can't see how they can determine your need for a pump or not!

But hopefully they sort you out quickly, and agree to a pump so it's easier for you to keep on the ever changing needs throughout the pregnancy..

 

[trophywench]

Usually a week for loan CGM, at my clinic. However I know someone who had a much more modern machine (which your own sounds like) which she kept for about 3 or 4 days.

Long enough to have a bit of variety though - you know different scenarios etc in your days.

 

[hyper-Suze]

Hey M,

My clinic decided there and then to send me off with a sensor at the time of my pump assessment but I guess each area is different as in how many they have to loan and which is out on use.

The sensor I had was a Navigator and it was on loan for 4 days. (it had a separate unit for the results)

The one tip I would give is that the CGM's are to show the consultants that you have problem areas, patterns that a pump would help (even after the pregnancy) and I found that by having the results automatically and 'on tap' next to me was dangerous as I was responding to the highs and lows, thus erridicating the problem areas.
If you can, try as hard as you can to not look too much and give your pump team as much evidence that you need a pump.

I too feel that the pregnancy/pump care for us is like we're pushed to the front of the queue than other pump users as I am being funded for sensors thru the 1st trimester which they are taking off the other pumpers in my pct. I feel awful but then at the end of the day, baby takes presidence in my books, and I want to take every opportunity to help my baby develop the best it can.

 

[Monkey]

How weird - I thought I'd replied to this and it's not here. Sorry - I must look very rude now!

Ellie, I get that thinking completely, but the consultant is basically saying if a pump is the way forward he wants to see it asap, so I don't think they're trying to kill time. Altho things are changing almost daily, I guess it might help show whether things like gaps between injection and meal would make more difference (altho I did point out that in first tri, that's near on impossible to do anything about anyway!)

Suze, that's really good advice about not reacting too much. I'm intrigued to see what it'll show tho. All exciting!