Will I qualify for an insulin pump

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Are pumps ever given to type 2 patients on NHS? My HBA1c is always too high, and I have 3 or 4 hypos a week - so well out of control. I have 4 insulin injections each day. Would a pump be helpful? Any advice would be great. Thanks
 
I'm afraid I am type 1 insulin dependent diabetic and just waiting to see if I will qualify here in Scotland, I attended my clinic in February but haven't been sent my HB1A1c result, I a waiting to attend an appointment with a dietician firstly for a carb count check as the last one was probably 58 years ago in 1966 when I was diagnosed so hopefully someone reading this will be able to help with your enquiry.
 
Joybells said:
Are pumps ever given to type 2 patients on NHS? My HBA1c is always too high, and I have 3 or 4 hypos a week - so well out of control. I have 4 insulin injections each day. Would a pump be helpful? Any advice would be great. Thanks
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Not as far as I am aware.
I think it is also important to understand that pumps are not "plug and play". They need quite a lot of input from the user particularly in the early days and you still need to understand how insulin works and be able to carb count your meals. It is not necessarily an easy solution.

Which insulins are you using and do you carb count your meals and calculate your doses. Have you ever done a basal insulin test to see if your basal dose(s) is/are holding you steady in the absence of food? I appreciate that Type 2 diabetics on insulin do not get the education courses like DAFNE or other local equivalents, but you can educate yourself via the online BERTIE course, if you haven't done it already. If you are interested I will find a link.
I consider myself pretty well controlled and I still average about 1 hypo a day, albeit mostly pretty mild ones, so to me 4 hypos a week isn't bad, but obviously something to improve on. What have you done to try to prevent them? Have you figured out if it is your basal or bolus insulin causing them or is it exercise or illness or alcohol, in which case you may need to adjust your insulin doses to accommodate those factors. Usually it needs a bit of thought and planning ahead of schedule.
 
Joybells said:
Are pumps ever given to type 2 patients on NHS? My HBA1c is always too high, and I have 3 or 4 hypos a week - so well out of control. I have 4 insulin injections each day. Would a pump be helpful? Any advice would be great. Thanks
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They’re only given to Type 1s and even then many Type 1s don’t have one. They’re more work than injections and need good diabetes, insulin and carb knowledge.

What insulins are you using? Are you sure your basal dose is right? Are you carb counting and have you checked your meal ratios? Is there a particular time of day that you’re going hypo?
 
Joybells said:
Are pumps ever given to type 2 patients on NHS? My HBA1c is always too high, and I have 3 or 4 hypos a week - so well out of control. I have 4 insulin injections each day. Would a pump be helpful? Any advice would be great. Thanks
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The answer to me has always been no. Even though diabetes specialists have recommended a pump to me before, they’ve recommended it with the caveat that id need to fund the pump plus consumables
 
How low are your hypos? Are you able to treat them yourself or needing help? Do you have hypo awareness ie you feel low?

The standard target is up to 4% of the time below 3.9 is “good control”, and more than 4% is where it needs work. Thats an hour a day of being hypo that is still counted as good control. So 3 or 4 hypos a week doesn’t sound terrible to me, though I can understand it being more than you’d like
 
Hello all, thanks for all this advice. It seems that I misunderstood the pump as I thought the device worked out the insulin doses for you according to your blood glucose count. I use Lantus and Novo Rapid. I try to count my carbs but perhaps I need to educate myself a bit more on how to do this. I would welcome help to find the BERTIE info thank you. I don't know if it is basal or bolus insulin that causes the hypos. It was 1.30am at 2.9 this morning, and they come at different times of the day, but I do treat them OK so I suppose they are not too serious. It is comforting to read that you all have hypos so it is not so unusual.
 
Joybells said:
Hello all, thanks for all this advice. It seems that I misunderstood the pump as I thought the device worked out the insulin doses for you according to your blood glucose count. I use Lantus and Novo Rapid. I try to count my carbs but perhaps I need to educate myself a bit more on how to do this. I would welcome help to find the BERTIE info thank you. I don't know if it is basal or bolus insulin that causes the hypos. It was 1.30am at 2.9 this morning, and they come at different times of the day, but I do treat them OK so I suppose they are not too serious. It is comforting to read that you all have hypos so it is not so unusual.
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That 2.9 this morning..... was that a Libre reading or a finger prick? If Libre, did you feel hypo and did you double check it with a finger prick? the reason I ask is that Libre is prone to what we call "compression lows" where lying on the sensor in your sleep causes the tissue under the sensor that the filament is sampling to become compressed and this causes it to give you a falsely low reading, so it is wise to double check with a finger prick or at least look to see if the graph shows a sudden drop or if there has been a steady decline into "the red" whilst you have been asleep. A compression low will usually be a sudden drop, but always wise to double check unless you feel obviously hypo. You then need to follow up with a finger prick test 15 mins later to check that your hypo treatment has worked because Libre will almost always show your levels have dropped even lower 15 mins later due to the algorithm it uses to try to make up the time lag difference between blood glucose and interstitial fluid glucose. It is all a bit complicated, but Libre is not reliable in this situation and you need to revert to finger prick tests to clarify a hypo and that your hypo treatment has been successful 15 mins after eating/drinking it.
 
Thanks, that is very interesting. Mine was not a compression low but it is good to know about them. I saw the nurse yesterday and she has changed my insulin dosage. Perhaps that will improve matters. I have now been waiting two weeks to get some glucose testing strips from the pharmacy - but that is another subject!
 
Joybells said:
Thanks, that is very interesting. Mine was not a compression low but it is good to know about them. I saw the nurse yesterday and she has changed my insulin dosage. Perhaps that will improve matters. I have now been waiting two weeks to get some glucose testing strips from the pharmacy - but that is another subject!
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If you are getting test strips on prescription can you not get the prescription and go to another pharmacy.
 
Joybells said:
Thanks, that is very interesting. Mine was not a compression low but it is good to know about them. I saw the nurse yesterday and she has changed my insulin dosage. Perhaps that will improve matters. I have now been waiting two weeks to get some glucose testing strips from the pharmacy - but that is another subject!
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When you are using insulin, it really is important that you have test strips. If you drive a car you are legally obliged to have them, so do ring around other pharmacies to see if they have the test strips you need and then take your prescription to whichever one you find has them in stock.
 
Hiya, I was one of the beta testers of the Bertie course and it's great for understanding carb counting. However may I suggest you get a copy of "Think like a pancreas" by Gary Scheiner to gain an understanding of insulin use . It does cover T2 as well as T1. I found it invaluable.
 
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