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Questions for Consultant
- Thread starter Ref
- Start date
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SB2015
Well-Known Member
- Relationship to Diabetes
- Type 1
It may be useful if you are clear what you expect to get from switching from MDI to a pump.
There are a lot of posts on here about the pros of using a pump. in some areas it is difficult to get hold of a pump, so you might also find it useful to look at the NICE criteria of allocating pumps.
For me the key factor was the increased flexibility (ability to adjust basal rates to match my individual needs, various ways of delivering bolus (extended and multiwave) to match different foods, and ability to respond to unplanned events (using temporary change to basal rates). These things together took away the intense frustration I found on MDI.
Have a look at other posts on here for reasons why people find pumps so good.
I could go on in more detail but basically there is no way I would want to go back to injections now.
There are a lot of posts on here about the pros of using a pump. in some areas it is difficult to get hold of a pump, so you might also find it useful to look at the NICE criteria of allocating pumps.
For me the key factor was the increased flexibility (ability to adjust basal rates to match my individual needs, various ways of delivering bolus (extended and multiwave) to match different foods, and ability to respond to unplanned events (using temporary change to basal rates). These things together took away the intense frustration I found on MDI.
Have a look at other posts on here for reasons why people find pumps so good.
I could go on in more detail but basically there is no way I would want to go back to injections now.
Annette
Well-Known Member
- Relationship to Diabetes
- Type 1
She may well want to be sure that you know what you are getting into with a pump - ie that they are not an easy answer. So you know about carb counting and basal testing and adjusting and such like. (If you dont, do a search on here, there's loads of info.) And as SB says, know why you want one - what can it help you with (increased flexibility, ability to deal with such things as stress or hormones (prob not in your case but that was why I got mine).
Thanks.
I've read a lot about pumps - on here and elsewhere - had a brief chat with my GP and been quite open with my consultant that I'd like to talk about one. I know they are not an easy option but i'm prepared to put in the effort to make it work. For me, it is the slow digestion which means I either have to let my BGs rise before I bolus, in which case my HbA1c will never come down, or I hypo and then go high. Plus the amount of testing and injecting i'm having to do just isn't practical when i'm at work.
I've read a lot about pumps - on here and elsewhere - had a brief chat with my GP and been quite open with my consultant that I'd like to talk about one. I know they are not an easy option but i'm prepared to put in the effort to make it work. For me, it is the slow digestion which means I either have to let my BGs rise before I bolus, in which case my HbA1c will never come down, or I hypo and then go high. Plus the amount of testing and injecting i'm having to do just isn't practical when i'm at work.
Pumper_Sue
Well-Known Member
- Relationship to Diabetes
- Type 1
You will need to do a lot of testing whilst on a pump. If you have slow digestion have you thought of trying one of the non analogue insulin's?
For the consultant you need to explain why you think a pump will benefit you and how much work you expect to have to put into it as well. Do not set unrealistic expectations regarding what the pump will do either. Do make sure you let her know the pump is only as good as the user.
Hi Andy,
If I remember correctly you have had a TP and have problems with hypos after food. I have the same problems and find my pump invaluable because I can switch off the basal if I am going too low. I am self-funding a Dexcom CGM at the moment and when you choose your pump bear in mind that having a CGM intergrated pump will give you the option of having a CGM without having to pay for a remote receiver. I have found the CGM very helpful when trying to judge when to give my insulin after meals, sometimes I have to wait an hour or so. Its well known that a TP causes blood glucose to be 'brittle' and hard to manage without the stablising effect of glucagon so you should qualify for a pump ok.
Regards
Annie
If I remember correctly you have had a TP and have problems with hypos after food. I have the same problems and find my pump invaluable because I can switch off the basal if I am going too low. I am self-funding a Dexcom CGM at the moment and when you choose your pump bear in mind that having a CGM intergrated pump will give you the option of having a CGM without having to pay for a remote receiver. I have found the CGM very helpful when trying to judge when to give my insulin after meals, sometimes I have to wait an hour or so. Its well known that a TP causes blood glucose to be 'brittle' and hard to manage without the stablising effect of glucagon so you should qualify for a pump ok.
Regards
Annie
Thanks, some interesting stuff to think about. I hadn't thought about non analogue insulin.
My consultant has mentioned a pump in the past, prior to my surgery so I don't think she's surprised I've raised it now. I've worked really hard to make the MDI approach work - i'm meticulous about carb counting, making sure my basals are right, testing and reviewing regularly - but it's just not happening. The hypos are doing me in, I had 2 yesterday, 1 while on the conservatory roof 😱.
You remembered correctly Annie. I'll bear that in mind about a CGM - up to now I've just been thinking about a libre. I didn't realise you got a choice of pump.
My consultant has mentioned a pump in the past, prior to my surgery so I don't think she's surprised I've raised it now. I've worked really hard to make the MDI approach work - i'm meticulous about carb counting, making sure my basals are right, testing and reviewing regularly - but it's just not happening. The hypos are doing me in, I had 2 yesterday, 1 while on the conservatory roof 😱.
You remembered correctly Annie. I'll bear that in mind about a CGM - up to now I've just been thinking about a libre. I didn't realise you got a choice of pump.
Northerner
Admin (Retired)
- Relationship to Diabetes
- Type 1
I wonder if @pottersusan has seen this -also with TP, uses pump and CGM 🙂
pottersusan
Well-Known Member
- Relationship to Diabetes
- Type 1
If I had any choice in the matter (which I don't!) I'd have a pump and cgm that communicate. The main advantage of a cgm over the libre, as I see it, is that the cgm warns you audibly of impending hypos and when your bg is dropping faster than normal. When you're busy - it's invaluable.
I'm going to be having another 'discussion' with my consultant later this month about another application for cgm funding - in which he would provide sufficient evidence of 'clinical exceptionality' (unlike last time).😡
Having a pump really changed my life. I was injecting 10/12 times a day😱 (because of being a gutless wonder!) . It involves a lot of hard work and commitment - it's certainly not the easy option to start with. However, it's worth the work.
If I had to choose one or the other, I think I'd go for the cgm (by the smallest of margins) as it's a lifesaver. The pump is more convenient. In my opinion - I'm only slightly biased
- us people without a pancreas ought to get both a pump and cgm.
I'm trying to find out, but they are not communicating with me, whether the consultant said I was T1 when applying for the pump funding. This has an impact on the application for the cgm funding.
I'm going to be having another 'discussion' with my consultant later this month about another application for cgm funding - in which he would provide sufficient evidence of 'clinical exceptionality' (unlike last time).😡
Having a pump really changed my life. I was injecting 10/12 times a day😱 (because of being a gutless wonder!) . It involves a lot of hard work and commitment - it's certainly not the easy option to start with. However, it's worth the work.
If I had to choose one or the other, I think I'd go for the cgm (by the smallest of margins) as it's a lifesaver. The pump is more convenient. In my opinion - I'm only slightly biased
- us people without a pancreas ought to get both a pump and cgm.I'm trying to find out, but they are not communicating with me, whether the consultant said I was T1 when applying for the pump funding. This has an impact on the application for the cgm funding.
Thanks. I don't think I'm going to get the choice either, though my consultant always makes a point of saying i'm not type 1. For now, if I can get a pump and avoid the almost daily hypos i'll be happy. I'll think about a CGM later, though I might chance my arm if things are going well Time for some pump research...
Time for some pump research...
trophywench
Well-Known Member
- Relationship to Diabetes
- Type 1
I didn't get a choice - it was a Roche Combo, a Roche Combo or a Roche Combo. As far as I know, my clinic doesn't have a clue about any other sort. I suppose if you moved from somewhere else already with an Omnipod or an Animas Vibe etc, they could refuse to offer any assistance - but how much assistance you might get is a bit debateable. They are already one DSN short at my clinic, and no sign of the other one recovering enough to return to work at the moment - she's been off for 18 months and doesn't even have a diagnosis yet according to her son-in-law (who my son-in-law happens to work with) about 3 weeks ago.
No idea what's happening at the clinic at all.
No idea what's happening at the clinic at all.
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