Advise on pump please

Hi,
Ive had diabetes for 38 years now, no major complications as yet thank goodness. Done dafne course last year and what a difference it has made, feel as if I am back in control after many years of guess work. My problem is I am on very small amounts of insulin, 3u of BI twice daily and 0.5:1 ratio breakfast and lunch, 1:1 ratio for dinner. Even with these small amounts bg can fall, it has been recommended that I should consider the pump. I was hoping to hear from anyone who has had experience with the pump, advantages and disadvantages etc. How do you manage with day to day tasks and do you find carrying the pump around a hinderence or can you forget about it through time
How easy is it to calculate insulin requirements on the pump compared to dafne rules or are they much the same.
Many thanks in advance for any help given.

I have just recently went on the pump and its amazing, I need large amounts, so my problem isn't the smaller dose delivery........I benefit from the different QA delivery methods, and the more effective BI delivery...........

The pump would make your problem so much more manageable........

Another advantage I have experienced is weight loss..........injecting insulin is only 50% effective, so half the dose isn't getting used up, which makes its easier for the encouragement of fat storage....I am now on half the insulin, its amazing............I realize that any less and you would be cured..... .....but you can see my point......

I suppose for some it may be hard to accommodate the pump during day to day life, but for most its easy, almost undetectable, it just clips on to your belt/bra..........and there are holders you can buy that increase the available sites..............

I suppose for woman, going to the loo may be a pain if your wearing trousers and have it attached to your belt.......

It really is non invasive, but I personally think that the benefits out weight the nuisance, and its only a nuisance for the first week......

On most pumps there is a bolus wizard for your QA needs, you can program in your ratios, sensitivity, corrections and so on, so all you need to do is test your blood....(which can then be sent wirelessly to the pump)....and put in the carb amount........(input as grams as opposed to CPs)...and the pump works out the dose for you, confirm with a push of a button.....DONE.........

the dose adjustment is still the same as DAFNE, so looking for patterns over 2 - 3 days etc.........

I could go on for longer, but if you have any other questions don't hesitate...........

I have not gone on to the pump, though DAFNE was supposed to be the first step before changing the a pump.
I have found the DAFNE course a big help and the doctors said that I did not need to consider the pump if I was not interested.

Two people from the course went on to a pump while a third has tried to get on a pump but has been refused, though his control is very bad and that is why he has been rejected.

I didn't fancy using the pump, but from what I have read, people who have gone on to a pump have found it very good.

Many thanks for replies,
I feel the same as you PNThomson, and said I would consider the pump as last resort but I have been advised to seriously consider its use as may help me manage my sensitivity to insulin and help prevent my frequent low bgs. My head is spinning with all the information I have taken on board so far and it is good to hear how well people are doing on the pumps.

Its good to hear all the positives about the pump novorapidboi26, to be honest I think what is putting me off more than anything is the constant reminder with the pump being attached all the time, but I suppose it is something I would manage to get over through time. It would be worth it if it helps, my poor children are fed up with being kept waiting for mums bg getting back to normal . If you don't mind me asking do you need to cover any of the cost for the basic running of the pump or is it all covered with prescriptions? Also did you have a choice in which pump to use or is that decided for you?

No cost for me.......

The pump is actually funded by the government, so a special fund was set up because pump availability was so bad in Scotland......

The normal process would be having to apply for funding from the local PCT, they would the take on the cost for you...

All my consumables, so, insulin vials, reservoirs, tubing and cannula are all paid for and provided for up front, so I have a large box full of stuff.....again, normally these items are paid for by your GP, just as with any prescription....

My pump centre at Monklands only used 2 kinds of pumps, for no reason other than keeping the training easier for them to teach.....I was basically put on the Medtronic 775, which has a larger reservoir than the others, so I suppose I did t have a choice but that didn't bother me......different centres may have a larger choice and may let their pumpers pick.....

It's definitely worthwhile if your quality of life is being affected.....

Being connected all the time is a thought that many think may bother them, the reality is you just don't know it's there....

For me the pump was asset resort, it wasn't something I could choose, it's a difficult to get one....

Hello Sheila,

I have found the book "Success with your Insulin Pump" by Jill Rodgers very informative.

I would love a pump, but have been told that my control is too good to warrant the expense. The control is good - deliberately, but would be easier with modern technology, blood glucose levels would be easier to monitor - if you have a pump that has a monitor permanently attached and linked to the pump, so safer, plus I think that we all need to keep on moving with the times, we wouldn't expect people to control type 1 in the same way they did 20 years ago, and it does cost more, but better control means less complications and so less cost to the NHS.

Any way, rant over, there is a site aimed at type 1 and pumps called Shoot Up or put up - http://www.shootuporputup.co.uk

I quite enjoy reading some of the stuff on here.

Gosh Simon, that does seem harsh - being denied access to new technology because you are doing so well!

We are lucky here in that the local trust recognises the long term cost savings of Dafne and pumps. In fact I was told on my Dafne course that I was a good candidate for a pump as, like Sheila, I am highly sensitive to insulin and take miniscule amounts. This makes control difficult as small errors have a big impact. So it does seem that one's postcode effects one's treatment.

I would hardly call your grumble a rant - if we can't voice our feelings on this website where can we?

Many thanks for the replies they have been a good help.

Thank you NuMo I will have a look out for the book, it is always good to hear what other people have found helpful.

Simon I think it is wrong that you could not be considered for pump therapy due to good control, it is very frustrating. I am fortunate that my healthcare team have got funding at the moment, but that doesn't guarantee that I will be accepted for the treatment. Hopefully through time things will change for the better. I found the website you recommended very helpful. Thank you.

Thank you novorapidboi26, your information answered a lot of my questions. If I decide to go ahead I know it won't be until end of year beginning of next, I know the pct has funding at the moment but as I said to Simon there is no guarantee that I would meet all the criteria needed to go onto pump therapy, only time will tell. It is good to hear that you are doing well with the pump.

Thank you all again for taking the time to respond it has been a great help and is very much appreciated.

Sheila

Good luck with your application to get on the pump therapy list - I suspect that if the team have already discussed the possibility and said there is funding available you stand a good chance - else why mention it. Whilst they do cost a lot of money, the NHS does recognise that in the long run they save money - as the control that can be achieved can be significantly better than the multi dose way.

That said, they are not for everyone, and they do require a lot of work - esp at the beginning, so I hope it does work for you,, and it helps deal with your particular problem.

Let us know how it goes.