It seems to be the month for group therapy. Following my local Diabetes UK meeting a couple of weeks ago I spent a happy few hours last night in our local hospital. They run a coffee evening a couple of times a year for all those who’ve mastered the dark art of carb counting and insulin adjustment through their training programme, or who have a pump.
Put 15 pancreatically challenged types in a room with a nurse consultant and a pump specialist nurse and you can have a great little chat and catch up on the local gossip…
The hypo/pump/driving tightrope. It was interesting to hear the pump team say that they’re starting to see patients have to tread a fine line – previously when they were applying for pump funding, pancreatically challenged types would major on any hypo issues they were experiencing to help them meet the NICE criteria for pumps. But now, people are more wary of doing that, because if you report more than two major hypos in a year, the DVLA can review your suitability to drive . So they’re stuck between a rock and a hard place – the easiest way to get a pump is to be honest about any hypo issues, but in reality that can also leave you exposed to potential DVLA issues. This was exactly Dave’s comment recently.
Someone sees sense on pump insurance. It seems our local diabetes network have decided that they no longer require people to insure their own pumps, following guidance from Diabetes UK “People with diabetes have reported being asked to insure their insulin pump themselves, despite the insulin pump being the property of the NHS. Diabetes UK believes this is an unfair burden that should not fall to the individual with diabetes and/or their carers. The NHS and pump suppliers should work towards resolution of this issue.” That’s nice for me because that was the approach I’d taken anyway. It’ll be interesting to see if teams across the country do the same.
Exercise. It’s always interesting to hear how other people deal with exercise because I find it can be a bit of a black art. The general consensus seems to be to reduce basal a few hours before, and reduce the bolus for any meal eaten up to an hour before exercise – for me, for an hour’s fast swimming I’d reduce my basal to 25%, 90mins before swimming, eat a light meal about an hour for and only bolus for about 40% of it.
For those with any serious interest in sport, www.runsweet.com has some useful tips. My favourite from last night, which had never crossed my mind, was to do a short sharp burst of intense exercise at the start of a session to force the body to produce the exercise hormones that naturally raise blood sugar. This should help stop you dropping during the session. And consider doing the same at the end, to delay any post exercise blood sugar slump. It’s certainly worth a try.
Patients can be powerful. It was good to hear the pump team talking about how genuinely valuable patient feedback is to them – it gives them ideas for what they need to be doing next and helps them to improve. But it also gives them ammunition – often when trying to improve services a well-informed patient voice can carry a great deal of weight in getting issues addressed – so far that’s proving to be the case with my eye clinic situation.
Quote of the night…“Can someone tell Medtronic to speak English – my pump told me to check for an occlusion the other night and I had to look it up in the dictionary to find out what it was.” Now I come to think of it, it’s not a word that had ever entered my world before I started pumping. Surely calling it a blockage would be simpler.