I’m a little taken aback, actually saw the Consultant today.
Usually its annual appointment* (read 18 monthly in reality) role in see some registrar, answer the same set of questions and off we go home again….
This year however its time to throw the script out.
Apparently while my colestral is high and has gone up and they have been threatening colostral tablets for the last 3 years apparently its a silly idea and collestral tablets are not needed. Even though I have a family history of heat disease and diabetes….. (I knew there was a reason why I was ignoring the registrars)
Anyway the he said the best way to bring my blood sugar down first thing in the morning would be a pump and I should defiantly think about it, Think about it and if you want I can refer you to St Barts. (They don’t have a pump program at Medway yet. However they do have a Pump program at Dartford who Medway are merging with so we should have a pump program soon. but he was not sure when it was going to happen and if I wanted a pump now I would need to go up to London……
He also said a HBA1c of 8.4 was fine even though its above the magic 8 and was nothing to worry about……
Lets just say by the end of the appointment I was struck a bit dumb and did not know what else to say.
Anyway the real question, do I look at a Pump? I’ve been on using Dafnee for the last 3 years and while I don’t CP count as much as I should my guesses are not too far out.
Hi Peter .. yes go for the pump! Try it …if its a big no and you really don’t like it then you can give it back. Bet you don’t though. Its like all diabetic changes it takes a bit of getting use to and yes you do have to initially work hard but you do have more control and insulin on board 24/7.
Alison and Tim will prompt you to relevant blog posts and others will give you an insight. Good luck though and go for it!
I had not really thought a pump was an option, (even if it does mean going up to London to get one, London is not that far, I used to work there
I’d been thinking for a while a pump might help, but I’d not really it as a possible solution and had “ignored the idea” As I had heard Pumps were always a bit pie in the sky for people who’s diabetes control was “OK/Manageable” without, and were only really given to people who could not control there diabetes at all no matter how much they tried.
The thing I guess I’m most worried about at the moment is the idea of tieing myself in knots in my sleep. I tend to be a very “restless” sleeper, But I guess if my blood sugar was exactly right it might solve that issue……
Lets just say the idea is growing on me currently.
I’m a very restless sleeper, and it took me about a week to get used to the pump at night. Now I dont notice it, it just moves with me. You just need to find how best to ‘store’ it in bed (clipped to your pjs, roaming free, on a cord – just find your own solution).
But, I have a question. Since when has ‘8’ been the magic number? I’d always understood the goal to be 7, and above 8 was getting into danger territory. Does that goal change with PCT as well? (I know cholesterol levels and when they’ll put you on statins changes between areas – I got statins at a lower level than alot of people I know, because my PCT is big on heart disease, or something)
I went onto the pump in November and wouldn’t look back. I was convinced I could achieve similar control with obsessive MDIing and had a short but intense couple of months of internal debate as to whether the pump would be a good thing. It doesn’t guarantee perfect control and anyone who tells you it does is fibbing. What it does do is give the opportunity for much finer control using more advanced techniques than MDI can give such as square wave bolus and 0.1unit delivery. You may also find your HBA1c doesn’t automatically improve very quickly or even in the medium term but instead of peaking and troughing ski slope graph it’s a much smoother trendline that’s a sits little higher than your previous average.
I agree with the rest of them Peter. Also, you might want to take a look at our pump basics section – it has a few articles about what Tim and I get out of using pumps, how we live with them, things to thing about before you start pumping, and right at the bottom some basics about pumping: http://www.shootuporputup.co.uk/tag/pump-basics/
The 8% or below I was told was the current target a few years back, although it seams to depend on who to talk to and what they feel like who and whether they range Type 1 or Type 2 into the argument….. When I first had HBA1c back 20 years ago they said the aim was 12% or below then 10%. back then as a teenager I could manage 4% and used to shock them but that was years ago……. so my memory might be a bit flexible.
Anyway we should’t be using the % anyway have they not changed the scale?
I would like to achieve an average a little below my current average of 9.8 say 8.0 but that might be just my forgetfulness and trying to sort it out afterwards…..
I’m not necessary a resister I just want to ensure I know all the ins and outs before I start making trips on the off chance that it might work….
From what I’m reading Pumps are likely to become the “Expected Norm” within the next 10 years rather than the 1% of type 1 diabetics in this country it is currently, (or at least closer to the USA 10% or the European 12%). I’m wondering if its a bit like the move to human insulin we had a few years back…..
Another pump newbie (and spent MANY years actively resisting the idea). I am now, I think, pretty much entirely converted. The precision and flexibility of delivery makes MDI look like a very blunt instrument. A pump won’t solve everything and won’t suit everyone, but after you’ve tried all the insulins and options available on MDI it will still be there at the end of the tunnel offering all the benefits that the pump-evangelists harp on about.
I think pumps are becoming more common, and we’ve certainly a long way to go compared to other places, but research by John Pickup reckoned that about 20-25% of people would benefit from a pump, not everyone. I’d guess because, in the words of my own pump, http://www.shootuporputup.co.uk/2010/10/from-one-pump-to-another/ they’re a clever bit of kit but they’re only as good as the idiot they’re attached to.
Re targets – Diabetes UK recommedations in old money are below 6.5%, or below 7.5% for those at severe risk of hypos (whatever that means). http://www.diabetes.org.uk/HbA1c I aim for as low as I can get, without having hypo issues.
Hello Peter, I found the time I spent considering whether to use a pump or not more worrying than the actual doing it. I couldn’t imagine what I would do with a pump and tubing attached to me full time and the thought of ;
I’m on a pump & I love it, but … It’s not for everyone & isn’t the only way to good control, it is however very flexible which makes it easier to adapt to your needs!
If you can, get a loaner pump, that’ll answer a lot of your worries. The first few months are likely to be frustrating as you try to find the settings you need & finding the settings needs work but in my opinion its worth it!
One of the things you’ll have do is test your basal (background) insulin rate, I’ve never heard of this being done on mdi but if you decide to stay on mdi it may be worth doing because when I adjusted when I gave myself my bolus my control improved immensely.
On mdi you can’t stop your insulin running out but you can move when it happens to a time when you can correct it & splitting your bolus into two can also help.
Hi Peter, to reassure you about the tying yourself in knots, at Barts I think they will offer you the omnipod pump which doesn’t have any tubes but has a fancy wireless controller (http://www.myomnipod.com/)
Also the hospital is great- I’ve been going there for a decade. On my last visit to the nurse she asked if I would like to trial a pump to see if I like it, so I’m not sure that the waiting list will be that long! After that appointment I’ll be getting a (temporary) CGMS next week, followed by a pump to play with in April- but this wait is mostly so that I can start in the school holidays when I’m off work. Not sure how long the wait will be if I decide I want one permanently…
Anyway, just wanted to reassure you that I’m sure the team at Barts won’t just stick you on something that you’re not happy with