DAFNE to PUMP conversion

April 11, 2015 17:16

David Hales DAFNE Graduate
Calderdale and Huddersfield NHS Foundation Trust 12 posts

I have been on the DAFNE course and like most people, I found it really good.
However, now on a pump, I wondered if there was "conversion material" I could access to make the principles relevant to a pump user? I guess that the main approach is the same - carb counting, recording, step approach etc - but there must be some difference or there wouldn't be separate courses.
Can anyone help on this, please?

April 13, 2015 08:11

Pepsi DAFNE Graduate
Cambridge University Hospital NHS Foundation Trust 8 posts

Hi David
Cant help with your question, sorry , but have questions maybe you could help me with. I have been approved for a pump, but yet to choose one. Are you finding better control etc with the pump? Do you regret changing at all?

April 19, 2015 10:55

Peter DUAG Committee Member
University College London Hospitals (UCLH) 109 posts

There is a DAFNE Pump course, but that's only offered by a few DAFNE Clinics. I transferred to a pump in November last year and have found that the same principles still apply. I was given ~3 hours training on the operation of the pump (Omnipod in my case) by an ex-DSN from the supplier. The rest was left up to me and, with the number of options for changing settings, it certainly took time to get to the point where I felt in control.

April 19, 2015 18:51

Vickyp DAFNE Graduate
County Durham and Darlington NHS Foundation Trust 137 posts

I went on the omnipod pump 3 months after finishing my dafne course. It was during the course that I became interested in a pump and looking at the choices chose the omnipod. My consultant said Medtronic as I could get a cgm that goes with it but I didn't want tubes so he agreed to get me omnipod.
I had 3hr training session from the ypsomed rep and my DSN, a saline filled pod for a weekend before going 'live'. I then had another session after 4weeks to ask further questions etc, and am in regular contact with consultant/DSN. It was the best decision I made, even tho there is little change to my hba1c (was 6.1 on MDI but had multiple daily hypos....still around 6.1 but with very few hypos if any some months....so better control!) Very Happy

April 19, 2015 21:10

David Hales DAFNE Graduate
Calderdale and Huddersfield NHS Foundation Trust 12 posts

Pepsi said:
Hi David
Cant help with your question, sorry , but have questions maybe you could help me with. I have been approved for a pump, but yet to choose one. Are you finding better control etc with the pump? Do you regret changing at all?

The pump gives me far better control. I have never heard of anyone giving a pump back! The small downside is managing the very fine tube - but you get used to this. An Omnipod doesn't have a tube, but has a smaller capacity and therefore has to be changed more often

April 19, 2015 21:18

David Hales DAFNE Graduate
Calderdale and Huddersfield NHS Foundation Trust 12 posts

[Shared diary only visible when logged in]

Thank you to everyone that replied. Much appreciated.
I am on a fairly low daily dose of insulin and any small error in estimating carbs has a significant effect on my BGs. Similarly, any additional activity has a big lowering of BGs. It's very difficult to get any stability or predictability. Just look at today's record - 14.4 before going for half an hour walking the dog and 2.7 when I got back. I didn't walk particularly fast!

April 19, 2015 21:32

David Hales DAFNE Graduate
Calderdale and Huddersfield NHS Foundation Trust 12 posts

[Shared diary only visible when logged in]

Sorry - I uploaded an incomplete record of today - here it is...

May 06, 2015 11:27

novorapidboi26 DAFNE Graduate
NHS Lanarkshire 1,819 posts

I would say the principles are exactly the same apart from the basal adjustment........

counting carbs stays the same, the approach to adjusting your meal time bolus is the same............

basal adjustment is same on some levels but being able to adjust by the hour/half hour makes it a little more challenging if you want to fine tune it.......

how are your basal rates, any issues?

May 06, 2015 19:54

Stew B DAFNE Graduate
Norfolk and Norwich University Hospital 125 posts

Hi David, I gave a pump back after five months. Although I found it straightforward to manage, and it had some advantages, I found some of the practicalities tedious and emotionally I didn't like being reminded 24/7 that I have diabetes.

My diabetes centre were brilliant - I was well supported when I was on the pump, and there was no sense of failure when we agreed that I would come off it.

I've returned to DAFNE and things are fine now!

Stew

May 10, 2015 16:00

David Hales DAFNE Graduate
Calderdale and Huddersfield NHS Foundation Trust 12 posts

Thank you for the reply novorapidboi26
My basal rates are also pretty small from 1 unit per hour in the morning to 0.1 unit per hour mid-afternoon. Therefore I guess any small difference in insulin or carbs has a significant effect on my control. Therefore, I am fairly OK eating in as the carbs are on the packet or I can weigh, but eating out always trips me up by me not knowing the exact ingredients or weight.

novorapidboi26 said:
I would say the principles are exactly the same apart from the basal adjustment........

counting carbs stays the same, the approach to adjusting your meal time bolus is the same............

basal adjustment is same on some levels but being able to adjust by the hour/half hour makes it a little more challenging if you want to fine tune it.......

how are your basal rates, any issues?

April 11, 2015 17:16 David Hales DAFNE Graduate Calderdale and Huddersfield NHS Foundation Trust 12 posts	I have been on the DAFNE course and like most people, I found it really good. However, now on a pump, I wondered if there was "conversion material" I could access to make the principles relevant to a pump user? I guess that the main approach is the same - carb counting, recording, step approach etc - but there must be some difference or there wouldn't be separate courses. Can anyone help on this, please?
April 13, 2015 08:11 Pepsi DAFNE Graduate Cambridge University Hospital NHS Foundation Trust 8 posts	Hi David Cant help with your question, sorry , but have questions maybe you could help me with. I have been approved for a pump, but yet to choose one. Are you finding better control etc with the pump? Do you regret changing at all?
April 19, 2015 10:55 Peter DUAG Committee Member University College London Hospitals (UCLH) 109 posts	There is a DAFNE Pump course, but that's only offered by a few DAFNE Clinics. I transferred to a pump in November last year and have found that the same principles still apply. I was given ~3 hours training on the operation of the pump (Omnipod in my case) by an ex-DSN from the supplier. The rest was left up to me and, with the number of options for changing settings, it certainly took time to get to the point where I felt in control.
April 19, 2015 18:51 Vickyp DAFNE Graduate County Durham and Darlington NHS Foundation Trust 137 posts	I went on the omnipod pump 3 months after finishing my dafne course. It was during the course that I became interested in a pump and looking at the choices chose the omnipod. My consultant said Medtronic as I could get a cgm that goes with it but I didn't want tubes so he agreed to get me omnipod. I had 3hr training session from the ypsomed rep and my DSN, a saline filled pod for a weekend before going 'live'. I then had another session after 4weeks to ask further questions etc, and am in regular contact with consultant/DSN. It was the best decision I made, even tho there is little change to my hba1c (was 6.1 on MDI but had multiple daily hypos....still around 6.1 but with very few hypos if any some months....so better control!)
April 19, 2015 21:10 David Hales DAFNE Graduate Calderdale and Huddersfield NHS Foundation Trust 12 posts	Pepsi said: Hi David Cant help with your question, sorry , but have questions maybe you could help me with. I have been approved for a pump, but yet to choose one. Are you finding better control etc with the pump? Do you regret changing at all? The pump gives me far better control. I have never heard of anyone giving a pump back! The small downside is managing the very fine tube - but you get used to this. An Omnipod doesn't have a tube, but has a smaller capacity and therefore has to be changed more often
April 19, 2015 21:18 David Hales DAFNE Graduate Calderdale and Huddersfield NHS Foundation Trust 12 posts	[Shared diary only visible when logged in] Thank you to everyone that replied. Much appreciated. I am on a fairly low daily dose of insulin and any small error in estimating carbs has a significant effect on my BGs. Similarly, any additional activity has a big lowering of BGs. It's very difficult to get any stability or predictability. Just look at today's record - 14.4 before going for half an hour walking the dog and 2.7 when I got back. I didn't walk particularly fast!
April 19, 2015 21:32 David Hales DAFNE Graduate Calderdale and Huddersfield NHS Foundation Trust 12 posts	[Shared diary only visible when logged in] Sorry - I uploaded an incomplete record of today - here it is...
May 06, 2015 11:27 novorapidboi26 DAFNE Graduate NHS Lanarkshire 1,819 posts	I would say the principles are exactly the same apart from the basal adjustment........ counting carbs stays the same, the approach to adjusting your meal time bolus is the same............ basal adjustment is same on some levels but being able to adjust by the hour/half hour makes it a little more challenging if you want to fine tune it....... how are your basal rates, any issues?
May 06, 2015 19:54 Stew B DAFNE Graduate Norfolk and Norwich University Hospital 125 posts	Hi David, I gave a pump back after five months. Although I found it straightforward to manage, and it had some advantages, I found some of the practicalities tedious and emotionally I didn't like being reminded 24/7 that I have diabetes. My diabetes centre were brilliant - I was well supported when I was on the pump, and there was no sense of failure when we agreed that I would come off it. I've returned to DAFNE and things are fine now! Stew
May 10, 2015 16:00 David Hales DAFNE Graduate Calderdale and Huddersfield NHS Foundation Trust 12 posts	Thank you for the reply novorapidboi26 My basal rates are also pretty small from 1 unit per hour in the morning to 0.1 unit per hour mid-afternoon. Therefore I guess any small difference in insulin or carbs has a significant effect on my control. Therefore, I am fairly OK eating in as the carbs are on the packet or I can weigh, but eating out always trips me up by me not knowing the exact ingredients or weight. novorapidboi26 said: I would say the principles are exactly the same apart from the basal adjustment........ counting carbs stays the same, the approach to adjusting your meal time bolus is the same............ basal adjustment is same on some levels but being able to adjust by the hour/half hour makes it a little more challenging if you want to fine tune it....... how are your basal rates, any issues?