# Insulin pumps



## Lily123

I was  wondering about getting an insulin pump. By the NICE guidelines the way I would qualify would be due to my HbA1C coming down due to hypos. Does anyone know what pumps are available in the Buckinghamshire area?


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## SB2015

Hi @Lily123 it would be worth you contacting your team.

If you are still in Paeds you might have more chance of accessing a pump, if now in adult care just gather data linked to the NICE guidelines and present it to your team.  In general they are keen to help us to manage our condition in the most appropriate way, with some financial limitations Imposed by the local CCG.  

Each area has contracts with particular pump manufacturers who then train their staff, and provide continued support , as well as funding the consumables.

Let us know how you get on.


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## helli

Sorry, I do not know the pumps in Bucks.
But wanted to add a note of encouragement. When I got a pump, my hba1c was around 50 but I was struggling with exercise - my levels would plummet in the gym and soar on the climbing wall. 
I have been pumping for 6 years and have a love hate relationship with it. I love the control and the ability to dose small amounts and the ability to adjust basal for exercise. But it still requires more thought than injecting when I could round up to 10g carbs and basal stayed the same. Pumping also feels like my diabetes is more on display. My latest tubeless pump has helped but, being slim, there is still a bump that I try to hide when I wear leggings.

Overall, pumping is much better and I encourage you to push for one. I am an example where the classic interpretation of the NICe guidelines were adjusted to get one.


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## Lily123

@SB2015 I am still under the childrens outpatients as I am 14. Thanks for the encouragement @helli ! My next appointment is sometime in February so I will ask then.I don’t mind if people see the pump (if I get one) or judge me for it. If anyone asks me about the Libre then I’m more than happy to explain it to them. ( I have a feeling I should care what my classmates think of me)


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## SB2015

Pumping made my life so much more flexible.

 I had had overnight hypos which the pump virtually eliminated because I was able to adjust the basal rate down at the time when I was usually having hypos, since my needs were not the same throughout the night.

As @helli mentioned exercise is a lot easier. On MDI I needed to know what I was going to do at the start of the day and life for me is just not like that.  With the pump it is possible to turn the basal insulin (a continuous dribble of quick acting through the day) down before during and/or after exercise.  You gradually find what works for you.  

The other bit I make good use of is the different ways of delivering a bolus to match the food I am eating. Those fatty meals like Pizza or curry were a pain on MDI, and I used to try splitting the injection, but then all too often forgot to do the second half.  On a pump you can ask it to deliver your Bolus over a period of time for those fatty meals.  You can also mix it and have some bolus up front for the quick acting carbs along with an extended bolus for the other bits.  

Topping up a bolus if the pudding is just too tempting is also easy.  Just tell your pump, deliver the xtra and enjoy.

Let us know how you get on.


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## Lily123

SB2015 said:


> Pumping made my life so much more flexible.
> 
> I had had overnight hypos which the pump virtually eliminated because I was able to adjust the basal rate down at the time when I was usually having hypos, since my needs were not the same throughout the night.
> 
> As @helli mentioned exercise is a lot easier. On MDI I needed to know what I was going to do at the start of the day and life for me is just not like that.  With the pump it is possible to turn the basal insulin (a continuous dribble of quick acting through the day) down before during and/or after exercise.  You gradually find what works for you.
> 
> The other bit I make good use of is the different ways of delivering a bolus to match the food I am eating. Those fatty meals like Pizza or curry were a pain on MDI, and I used to try splitting the injection, but then all too often forgot to do the second half.  On a pump you can ask it to deliver your Bolus over a period of time for those fatty meals.  You can also mix it and have some bolus up front for the quick acting carbs along with an extended bolus for the other bits.
> 
> Topping up a bolus if the pudding is just too tempting is also easy.  Just tell your pump, deliver the xtra and enjoy.
> 
> Let us know how you get on.


I struggled with hypos at lunch time and adjusted my breakfast ratio by 1 and that makes my numbers decide to go high. I find that a pump would be helpful for me because in the evening my numbers start rising and adjusting the dinner ratio makes me go hypo. Plus I haven’t attempted spilt doses because I know I would forget


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## SB2015

Lily123 said:


> I struggled with hypos at lunch time and adjusted my breakfast ratio by 1 and that makes my numbers decide to go high. I find that a pump would be helpful for me because in the evening my numbers start rising and adjusting the dinner ratio makes me go hypo. Plus I haven’t attempted spilt doses because I know I would forget


That sounds like a perfect recipe for a pump.  

Are you using half unit pens?  When on MDI that really helped me.  At the time they were only available in children‘s pens so I had nice coloured ones as well as stickers to go with them!!  The colours helps in my not muddling up Novorapid and Levemir (except when I put the wrong cartridge in the wrong pen!!).


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## Lily123

SB2015 said:


> That sounds like a perfect recipe for a pump.
> 
> Are you using half unit pens?  When on MDI that really helped me.  At the time they were only available in children‘s pens so I had nice coloured ones as well as stickers to go with them!!  The colours helps in my not muddling up Novorapid and Levemir (except when I put the wrong cartridge in the wrong pen!!).


Yeah I’m using half unit pens. I used to have different colour pens for the NovoRapid and Tresiba but on the old pen I used for Tresiba the end was that stiff I couldn’t do my own injection. So there both dark blue only a few times have I nearly done 23.5 units of NovoRapid instead of Tresiba!


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## Robin

Lily123 said:


> Yeah I’m using half unit pens. I used to have different colour pens for the NovoRapid and Tresiba but on the old pen I used for Tresiba the end was that stiff I couldn’t do my own injection. So there both dark blue only a few times have I nearly done 23.5 units of NovoRapid instead of Tresiba!


I ended up with two dark blue pens at one point, so I stuck a label on the basal pen and wrapped it with sellotape, and I got to know instinctively that the Levemir pen had a rough bit on it, and the novorapid was smooth. Now I’ve got a red one for bolus, but the label is still on the blue one, which helps first thing in the morning if it’s a bit dark!


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## Lily123

Robin said:


> I ended up with two dark blue pens at one point, so I stuck a label on the basal pen and wrapped it with sellotape, and I got to know instinctively that the Levemir pen had a rough bit on it, and the novorapid was smooth. Now I’ve got a red one for bolus, but the label is still on the blue one, which helps first thing in the morning if it’s a bit dark!


That’s a good idea


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## Pumper_Sue

Lily123 said:


> I was  wondering about getting an insulin pump. By the NICE guidelines the way I would qualify would be due to my HbA1C coming down due to hypos. Does anyone know what pumps are available in the Buckinghamshire area?


Hi @Lily123 just a suggestion for you, have you looked on your hospitals website to see what pumps are offered? I know some hospitals do say on there what is available.


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## Lily123

Pumper_Sue said:


> Hi @Lily123 just a suggestion for you, have you looked on your hospitals website to see what pumps are offered? I know some hospitals do say on there what is available.


I have tried the NHS website but can’t find the website for my hospital


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## Pumper_Sue

Lily123 said:


> I have tried the NHS website but can’t find the website for my hospital


Have you tried putting your hospital into your search engine?


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## Lily123

Pumper_Sue said:


> Have you tried putting your hospital into your search engine?


I’ve done that just now and found the website for the three hospitals for the county my hospital is in (the hospital is in a different county to me) If I put diabetes into the search on the website it only mentions about you get an insulin pump if you meet the NICE guidance and not what pumps my hospital actually offers


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## Inka

Lily123 said:


> I’ve done that just now and found the website for the three hospitals for the county my hospital is in (the hospital is in a different county to me) If I put diabetes into the search on the website it only mentions about you get an insulin pump if you meet the NICE guidance and not what pumps my hospital actually offers



That’s not uncommon @Lily123 My hospital updates its pump list frequently so it could be out of date if it was online. Ask your DSN and while you’re waiting for info, just do some general research about pumps - really broad research, so you know as much as you can.


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## Lily123

Inka said:


> That’s not uncommon @Lily123 My hospital updates its pump list frequently so it could be out of date if it was online. Ask your DSN and while you’re waiting for info, just do some general research about pumps - really broad research, so you know as much as you can.


Good idea - I will go and research


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## Leadinglights

Lily123 said:


> Good idea - I will go and research


Good on you, you seem a very switched on and knowledgeable and clearly have become your own expert. Very impressive for someone so young.


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## Lily123

Leadinglights said:


> Good on you, you seem a very switched on and knowledgeable and clearly have become your own expert. Very impressive for someone so young.


Yes but then theres the fear of researching then being told no by the clinic so researching continues. Thanks @Leadinglights for the encouragement


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## Thebearcametoo

Lily123 said:


> Yeah I’m using half unit pens. I used to have different colour pens for the NovoRapid and Tresiba but on the old pen I used for Tresiba the end was that stiff I couldn’t do my own injection. So there both dark blue only a few times have I nearly done 23.5 units of NovoRapid instead of Tresiba!


You can get a new pen prescribed. It’s a safety issue to have them different colours. It may take a conversation with the pharmacy to get the colour you want as they don’t always get a say in which come in their orders. 

Regarding the pump. Talk to your team. Here (Oxfordshire) funding for over 12s isn’t guaranteed but the team will work out how to give the best argument for funding and get them for all their teens. The process here is that they have info days 3-4 times a year and you go on that first to see what options there are and which you’re interested in and then at your next clinic say you want it and they put the funding bid in. Don’t wait until your February clinic drop them an email this week and start the process to see if you’re suitable for one and if they can get one funded for you. There are lots of benefits to having a pump but they’re not completely stress free. My kid is on another break and back on injections at the moment as he was fed up of it. 

Which pump you choose may depend on if you want to self fund for a dexcom or other CGM to link it to the pump otherwise they all have some pros and cons. Here they’re not offering omnipod to new patients but otherwise have a good variety of options.


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## Lily123

Thebearcametoo said:


> You can get a new pen prescribed. It’s a safety issue to have them different colours. It may take a conversation with the pharmacy to get the colour you want as they don’t always get a say in which come in their orders.
> 
> Regarding the pump. Talk to your team. Here (Oxfordshire) funding for over 12s isn’t guaranteed but the team will work out how to give the best argument for funding and get them for all their teens. The process here is that they have info days 3-4 times a year and you go on that first to see what options there are and which you’re interested in and then at your next clinic say you want it and they put the funding bid in. Don’t wait until your February clinic drop them an email this week and start the process to see if you’re suitable for one and if they can get one funded for you. There are lots of benefits to having a pump but they’re not completely stress free. My kid is on another break and back on injections at the moment as he was fed up of it.
> 
> Which pump you choose may depend on if you want to self fund for a dexcom or other CGM to link it to the pump otherwise they all have some pros and cons. Here they’re not offering omnipod to new patients but otherwise have a good variety of options.


I wouldn’t want a patch pump like Omnipod or accu chek solo (honestly I have no idea why) I also need to get a new pen because of the safety issue you said and although it works the end the pen where you dial up the amount of insulin pops out at random times and when the end it pressed in it makes a splintering sound although it works (both pens are Novopen Echo. They are in different colour cases but I still manage to get confused


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## Lily123

Thebearcametoo said:


> You can get a new pen prescribed. It’s a safety issue to have them different colours. It may take a conversation with the pharmacy to get the colour you want as they don’t always get a say in which come in their orders.
> 
> Regarding the pump. Talk to your team. Here (Oxfordshire) funding for over 12s isn’t guaranteed but the team will work out how to give the best argument for funding and get them for all their teens. The process here is that they have info days 3-4 times a year and you go on that first to see what options there are and which you’re interested in and then at your next clinic say you want it and they put the funding bid in. Don’t wait until your February clinic drop them an email this week and start the process to see if you’re suitable for one and if they can get one funded for you. There are lots of benefits to having a pump but they’re not completely stress free. My kid is on another break and back on injections at the moment as he was fed up of it.
> 
> Which pump you choose may depend on if you want to self fund for a dexcom or other CGM to link it to the pump otherwise they all have some pros and cons. Here they’re not offering omnipod to new patients but otherwise have a good variety of options.


In regards in sending an Email to the diabetes team , I will get one of parents to do that (I don’t have the Email) The chances of me getting a pump may be fairly good as they were very happy to fund the Libre. They said about it at the end of May last year and by early July I had my first sensor!


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## helli

@Lily123 good luck with the pump.
I think your success with the Libre may be a red herring. i hope not.
But more people have Libre than pumps and, in some areas, Libre have been prescribed instead of pumps to help with Type 1 management.

In your case, your Libre seems to have given evidence for the need for a pump but not everyone may see it that way. If you have a supportive and informed DSN, you should be ok. Unfortunately, not every one is so lucky.

Good luck, keep us informed and feel free to ask questions to help with your research. Quite a few of us have been through the ”justify why a pump would help me” discussions.


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## Lily123

helli said:


> @Lily123 good luck with the pump.
> I think your success with the Libre may be a red herring. i hope not.
> But more people have Libre than pumps and, in some areas, Libre have been prescribed instead of pumps to help with Type 1 management.
> 
> In your case, your Libre seems to have given evidence for the need for a pump but not everyone may see it that way. If you have a supportive and informed DSN, you should be ok. Unfortunately, not every one is so lucky.
> 
> Good luck, keep us informed and feel free to ask questions to help with your research. Quite a few of us have been through the ”justify why a pump would help me” discussions.


My paediatric team have been supportive and I had never even head of a Libre before they said they would put it on my prescription! I think my main need to get a pump is hypos that can’t be explained (if I adjust the ratio of the meal before that I go high so I think it’s basal but the rest of the time the hypos are down to meal ratio) and that the spikes that can vary from 8 o’clock at night to midnight. As right now my numbers have slowly started to creep up


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## Inka

Have you done a recent basal test @Lily123 ? You say your numbers are creeping up. I find my basal needs tweaks through the year and for you as someone who’s still growing, then it could be your basal needs changing as part of that. I can’t remember - what basal are you on?


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## Lily123

23.5 Tresiba at night - I only recently adjusted it a few weeks back and it didn’t stop the spikes. I don’t think I would manage to do a basal test because of school and at the weekend and school holidays the routine is thrown out the window


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## Inka

My thought would be to consider trying a different basal eg Levemir. It’s an awful lot more flexible because you have two injections a day so can adjust the day bit separately from the night part. Someone here recently stated that Tresiba didn’t work so well for women/girls compared to men due to hormonal fluctuations.

So, I’d trial a twice-daily basal to see if it helps at all. Apart from possibly improving things for you, it could also be useful evidence in your pump search.


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## Lily123

Inka said:


> My thought would be to consider trying a different basal eg Levemir. It’s an awful lot more flexible because you have two injections a day so can adjust the day bit separately from the night part. Someone here recently stated that Tresiba didn’t work so well for women/girls compared to men due to hormonal fluctuations.
> 
> So, I’d trial a twice-daily basal to see if it helps at all. Apart from possibly improving things for you, it could also be useful evidence in your pump search.


I’ll ask about maybe trying a different basal at my next appointment as the Tresiba could be the problem. Up until about September I was using Lantus


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## Lily123

I’ve done some research on pumps - thanks for the suggestion to research @Inka . I wasn’t aware quite how many different pumps existed. I think my pump of choice would either be the Tandem T-slim X2. Is it possible to use that pump without the Dexcom? Or the Medtronic 780g. The DANA RS looked like a really good pump but I don’t think I would be able to read the screen very well. I’m getting a tiny bit ahead of myself! I haven’t even asked my diabetes team if I could get funding for a pump yet!


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## Inka

I have the DANA RS and it’s fantastic  You use an app on your phone to control it so I rarely look at the screen - only to prime the cartridge, etc, every few days. When I first got the pump and saw how dinky it was,  the rep said “Oh, you won’t ever look at the screen” and I didn’t believe him but it’s absolutely true! The app is brilliant and you can do everything on it - bolus, change your basal, set a temp basal, etc. It’s the most popular pump by far at my clinic.


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## Lily123

Inka said:


> I have the DANA RS and it’s fantastic  You use an app on your phone to control it so I rarely look at the screen - only to prime the cartridge, etc, every few days. When I first got the pump and saw how dinky it was,  the rep said “Oh, you won’t ever look at the screen” and I didn’t believe him but it’s absolutely true! The app is brilliant and you can do everything on it - bolus, change your basal, set a temp basal, etc. It’s the most popular pump by far at my clinic.


I’m not overly keen on having a pump controlled by my phone - I am just about okay with using my phone for the Libre .I would prefer more old-school of controlling the pump from the actual pump


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## Pumper_Sue

Lily123 said:


> I’m getting a tiny bit ahead of myself! I haven’t even asked my diabetes team if I could get funding for a pump yet!


Hi Lily, if you want a pump, write down all the reasons you want one and how you think a pump will help you.
Being one step ahead is always a good start 
At 14 you come across as a very mature young lady who would do very well with a pump, so have my fingers crossed your wish is granted.


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## Lily123

Pumper_Sue said:


> Hi Lily, if you want a pump, write down all the reasons you want one and how you think a pump will help you.
> Being one step ahead is always a good start
> At 14 you come across as a very mature young lady who would do very well with a pump, so have my fingers crossed your wish is granted.


I might have solved the hypers in the evening issue but maybe not as it is school holidays I don’t have the same knock on effect of 30 minute walk home from school so I will know if the spike is solved in about a fortnight. Thanks for the compliment. I will make a list as that is a really good idea as at the end of the appointment when I’m asked if I have any questions my mind goes blank so writing it down should help


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## Inka

Lily123 said:


> I’m not overly keen on having a pump controlled by my phone - I am just about okay with using my phone for the Libre .I would prefer more old-school of controlling the pump from the actual pump



Ah, ok  Well, you can use the pump itself it you want to. I did for the first week or so because I was used to doing it that way with all my previous pumps. Then I tried the app and gradually switched over to just using that. The DANA screen is small but it mainly has icons - good size icons that you can see easily and which take up most of the screen. The numbers are big enough too.


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## Lily123

Inka said:


> Ah, ok  Well, you can use the pump itself it you want to. I did for the first week or so because I was used to doing it that way with all my previous pumps. Then I tried the app and gradually switched over to just using that. The DANA screen is small but it mainly has icons - good size icons that you can see easily and which take up most of the screen. The numbers are big enough too.


I will go back and research that pump again as what you have said has changed my opinion


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## Lily123

I have got this as a list so far, but I don’t know if this would meet the guidelines  for getting a pump


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## Inka

That’s a well thought-out list @Lily123 I’d add a little about why your current regime doesn’t work for doing those things. It was years ago that I got my pump but I did have to explain why no other options worked. So, if you keep that in mind, you’ll be ready to explain what you’ve tried to solve these issues and that it didn’t work. 

Have you looked at the NICE criteria? I found they helped focus me too.


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## Lily123

Inka said:


> That’s a well thought-out list @Lily123 I’d add a little about why your current regime doesn’t work for doing those things. It was years ago that I got my pump but I did have to explain why no other options worked. So, if you keep that in mind, you’ll be ready to explain what you’ve tried to solve these issues and that it didn’t work.
> 
> Have you looked at the NICE criteria? I found they helped focus me too.


The NICE criteria is what I’m nervous about as I’ve managed to adjust ratios to avoid most hypos I don’t actually meet any of it with a HbA1C of 53


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## Inka

Try focusing on your quality of life. For example, if somebody had technically solved nighttime highs by setting an alarm to bolus at 2am every night, they could claim that having to do that negatively impacted on their quality of life even though it solved the problem. If you can find some actual examples from your life, that would be good eg times when you had to go beyond reasonable to control your blood sugar, times when your education was affected, times when your sleep was disturbed.


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## Lily123

Inka said:


> Try focusing on your quality of life. For example, if somebody had technically solved nighttime highs by setting an alarm to bolus at 2am every night, they could claim that having to do that negatively impacted on their quality of life even though it solved the problem. If you can find some actual examples from your life, that would be good eg times when you had to go beyond reasonable to control your blood sugar, times when your education was affected, times when your sleep was


I have struggled with having to miss lessons because if I have PE the lesson before I will have to spend time in the medical room because of the hypo that is inevitable. I’ll add to the list. I also find that I spike after every meal because I always inject before eating (I would forget after)


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## Pumper_Sue

Lily123 said:


> I have struggled with having to miss lessons because if I have PE the lesson before I will have to spend time in the medical room because of the hypo that is inevitable. I’ll add to the list. I also find that I spike after every meal because I always inject before eating (I would forget after)


These are all very good points esp as they affect your quality of life. Write down all the things you have tried to solve the problems you have. 
Many people split their bolus if eating fatty or high protein meals. So a pump would help you do this as well because you can set different boluses to suit your meals.


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## rebrascora

Lily123 said:


> I’ll add to the list. I also find that I spike after every meal because I always inject before eating (I would forget after)


I think you might have that the wrong way around. You usually need to pre bolus earlier before a meal to prevent a spike rather than inject after eating, unless it is a tricky food like pasta or pizza when you need some up front and some after. How long do you currently pre bolus or do you inject and then eat straight away? Many people need longer pre bolus time at breakfast to prevent big spikes. For me it is 45mins in advance of breakfast but others just need 20 or 30 mins and some just 5 mins. You have to carefully experiment with it, adjusting it by 5 mins each day until the spike reduces to find out what works for you.

Libre has a facility to set an alarm, so you could try using that for when you split a dose.

I agree that your list is really well composed and you have an amazing level of maturity for someone so young. 
I think it may help if you can show examples on your Libre of where particular problems arise and where you would expect a pump to improve things, so perhaps start keeping a diary of particular incidents which illustrate the problems you are having and as suggested, the things you have tried to counteract them.


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## Lily123

rebrascora said:


> I think you might have that the wrong way around. You usually need to pre bolus earlier before a meal to prevent a spike rather than inject after eating, unless it is a tricky food like pasta or pizza when you need some up front and some after. How long do you currently pre bolus or do you inject and then eat straight away? Many people need longer pre bolus time at breakfast to prevent big spikes. For me it is 45mins in advance of breakfast but others just need 20 or 30 mins and some just 5 mins. You have to carefully experiment with it, adjusting it by 5 mins each day until the spike reduces to find out what works for you.
> 
> Libre has a facility to set an alarm, so you could try using that for when you split a dose.
> 
> I agree that your list is really well composed and you have an amazing level of maturity for someone so young.
> I think it may help if you can show examples on your Libre of where particular problems arise and where you would expect a pump to improve things, so perhaps start keeping a diary of particular incidents which illustrate the problems you are having and as suggested, the things you have tried to counteract them.


I only have time to prebolus about 5 minutes before breakfast and dinner but about 10 minutes before lunch as at school it’s a walk from medical to the canteen (I have packed lunch)


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## rebrascora

Lily123 said:


> I only have time to prebolus about 5 minutes before breakfast and dinner but about 10 minutes before lunch as at school it’s a walk from medical to the canteen (I have packed lunch)


That is why you always spike after meals then. 
I can understand the constraints of prebolusing at school but why do you only have 5 mins to prebolus before breakfast and dinner? I inject my breakfast bolus as soon as I wake up, before i get out of bed and then have a routine of washing and getting dressed before I have breakfast. I tend to make my breakfast straight away so that it is ready to eat as soon as Libre shows my levels are starting to drop and the insulin is kicking in. 
With a pump, you would still need to prebolus to prevent those meal spikes. 

You could try a slightly faster acting bolus insulin to see if that helps like I did. I used to need 75mins prebolus time at breakfast with NovoRapid but just 45mins with Fiasp. At other times of the day it is usually about 20-30 mins. Most people would hypo with these time scales, so you do need to be careful about experimenting with the timing and do it carefully.... perhaps on non school days when you have more time.


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## Pumper_Sue

Lily123 said:


> I only have time to prebolus about 5 minutes before breakfast and dinner but about 10 minutes before lunch as at school it’s a walk from medical to the canteen (I have packed lunch)


Ah you need at least 15 mins before you eat.
Perhaps ask if you can try Fiasp as that works quite quickly. I bolus a couple of mins before I eat.
Mind you with a pump you wouldn't have to go to the medical room as the insulin is already with you  So another pointer for a pump


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## trophywench

Except for lunch, your answer does not actually make sense unless you do not hold your own pens at home and they are kept away from you.


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## Inka

Lily123 said:


> I only have time to prebolus about 5 minutes before breakfast and dinner but about 10 minutes before lunch as at school it’s a walk from medical to the canteen (I have packed lunch)



Totally unrelated but are you saying you go to a medical place to inject? Do you keep your insulin pen with you? I also think I remember you saying something about going to medical to treat a hypo? You shouldn’t have to do that. Your hypo treatments should be with you so you can treat at once and when needed. 

You should also be allowed time to bolus when you need to.


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## Lily123

Inka said:


> Totally unrelated but are you saying you go to a medical place to inject? Do you keep your insulin pen with you? I also think I remember you saying something about going to medical to treat a hypo? You shouldn’t have to do that. Your hypo treatments should be with you so you can treat at once and when needed.
> 
> You should also be allowed time to bolus when you need to.


My insulin pen and BG meter and hypo treatments are always with me but I prefer to do my injection and treat a hypo in medical as it just seems easier than everyone making comments even after I have explained to them what I’m doing. I leave lessons 10 minutes early to get my injection done before lunch and that means the spikes after lunch aren’t as bad. And with doing my actual injection I can answer any questions anyone has but when I’m hypo I don’t have the patience


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## Lily123

rebrascora said:


> That is why you always spike after meals then.
> I can understand the constraints of prebolusing at school but why do you only have 5 mins to prebolus before breakfast and dinner? I inject my breakfast bolus as soon as I wake up, before i get out of bed and then have a routine of washing and getting dressed before I have breakfast. I tend to make my breakfast straight away so that it is ready to eat as soon as Libre shows my levels are starting to drop and the insulin is kicking in.
> With a pump, you would still need to prebolus to prevent those meal spikes.
> 
> You could try a slightly faster acting bolus insulin to see if that helps like I did. I used to need 75mins prebolus time at breakfast with NovoRapid but just 45mins with Fiasp. At other times of the day it is usually about 20-30 mins. Most people would hypo with these time scales, so you do need to be careful about experimenting with the timing and do it carefully.... perhaps on non school days when you have more time.


I’ll actually do that. I will weigh out breakfast then do my insulin then get ready for school then eat my breakfast (weighing out cereal by eye when the scales broke went wrong last time)


----------



## Inka

Lily123 said:


> My insulin pen and BG meter and hypo treatments are always with me but I prefer to do my injection and treat a hypo in medical as it just seems easier than everyone making comments even after I have explained to them what I’m doing. I leave lessons 10 minutes early to get my injection done before lunch and that means the spikes after lunch aren’t as bad. And with doing my actual injection I can answer any questions anyone has but when I’m hypo I don’t have the patience



You shouldn’t feel obliged to answer anyone’s questions if you don’t want to  In fact, persistent questioning could be seen as discriminatory and bullying. I made a complaint to my work once when colleagues were being intrusive. That put a stop to it. Often people don’t realise that they’re being irritating and unnecessarily putting the focus on you for no reason. I’ve become quite fierce about it as the years have gone by. Your tutor or teachers should put a stop to it. It’s not helpful and just serves to single people out.

If you’re going to medical as your own free choice, that’s fine, of course  But you should never feel compelled to, either directly or indirectly. If you were to ever have a bad hypo, you’d need to treat it in class anyway.


----------



## Lily123

Inka said:


> You shouldn’t feel obliged to answer anyone’s questions if you don’t want to  In fact, persistent questioning could be seen as discriminatory and bullying. I made a complaint to my work once when colleagues were being intrusive. That put a stop to it. Often people don’t realise that they’re being irritating and unnecessarily putting the focus on you for no reason. I’ve become quite fierce about it as the years have gone by. Your tutor or teachers should put a stop to it. It’s not helpful and just serves to single people out.
> 
> If you’re going to medical as your own free choice, that’s fine, of course  But you should never feel compelled to, either directly or indirectly. If you were to ever have a bad hypo, you’d need to treat it in class anyway.


It’s not so much persistent questions as it is people just looking at me oddly but i don’t mind apart from if I’m hypo then it gets to me
I choose to go to medical and the school nurses mum is T1 so she understands it better than anyone else.


----------



## helli

I agree with others that you list in great and that you need to explain why a pump would avoid the problems that you experience.

If you are not happy bolusing and treating hypos in class, a pump would not help.
Would you be willing to bolus with your pump in class? Would you be willing to adjust your basal in front of others in preparatory PE? Bear in mind that you will need to make adjustments about 30 minutes before you need them.

The advantages of a pump are
- you can take smaller doses. Are there times when you need to take less than half a unit of bolus?
- your basal is adjusted to suit different basal needs at different times of the day. Do you need more basal in the morning due to Dawn Phenomenon?
- you can adjust your basal at shorter notice. Are there times (such as PE) when you know that you will need more or less basal?
- you can adjust your basal for different “types” of day. Do you find your levels are higher or lower at the weekend or during your monthly cycle?

In your argument, you also need to be aware of the disadvantages of a pump.
- If you want to dose from the pump, it will need to be easily accessible which means it may be on display. This may be a pump under your clothing. Are you happy for this?
- setting up your pump can take a lot of trial and error. Is it the right time for you to go through the pain of this? If you are likely to take your GCSEs in the next few months, you may want to postpone pump start until afterward. Alternatively, if you are doing you GCSEs next year, now may be the time to start pumping because your basal needs may be higher when stressed.
- pumps can fail. This is rare but it can happen and if never happens at a convenient time. Are you willing to deal with the “embarrassment“ of your Libre going off because your pump has failed and your levels have gone high because you have had no basal. And then, calmly change your pump?

I hope this all makes sense and does not put you off asking for a pump. Despite the potential problems, I would fight hard if my DSN tried to take away my pump. It has made my diabetes easier to manage but is at least as much effort s injecting.


----------



## Lily123

helli said:


> I agree with others that you list in great and that you need to explain why a pump would avoid the problems that you experience.
> 
> If you are not happy bolusing and treating hypos in class, a pump would not help.
> Would you be willing to bolus with your pump in class? Would you be willing to adjust your basal in front of others in preparatory PE? Bear in mind that you will need to make adjustments about 30 minutes before you need them.
> 
> The advantages of a pump are
> - you can take smaller doses. Are there times when you need to take less than half a unit of bolus?
> - your basal is adjusted to suit different basal needs at different times of the day. Do you need more basal in the morning due to Dawn Phenomenon?
> - you can adjust your basal at shorter notice. Are there times (such as PE) when you know that you will need more or less basal?
> - you can adjust your basal for different “types” of day. Do you find your levels are higher or lower at the weekend or during your monthly cycle?
> 
> In your argument, you also need to be aware of the disadvantages of a pump.
> - If you want to dose from the pump, it will need to be easily accessible which means it may be on display. This may be a pump under your clothing. Are you happy for this?
> - setting up your pump can take a lot of trial and error. Is it the right time for you to go through the pain of this? If you are likely to take your GCSEs in the next few months, you may want to postpone pump start until afterward. Alternatively, if you are doing you GCSEs next year, now may be the time to start pumping because your basal needs may be higher when stressed.
> - pumps can fail. This is rare but it can happen and if never happens at a convenient time. Are you willing to deal with the “embarrassment“ of your Libre going off because your pump has failed and your levels have gone high because you have had no basal. And then, calmly change your pump?
> 
> I hope this all makes sense and does not put you off asking for a pump. Despite the potential problems, I would fight hard if my DSN tried to take away my pump. It has made my diabetes easier to manage but is at least as much effort s injecting.


I’m in Year 9 so if I get a pump it might be too close to my GCSEs in Year 11. The issue I have with bolusing in class is incase the person sat next to me can’t stand the sight of a needle and is needle phobic and with a pump I would be fine bolusing in class as there would be no needles for anyone to have a phobia about. With smaller doses it would be extremely helpful as depending on what the BG meter calculates the dose as it rounds it up or down to the nearest unit or half unit ( the meter is an Accuchek Aviva Expert)


----------



## Leadinglights

Lily123 said:


> I’m in Year 9 so if I get a pump it might be too close to my GCSEs in Year 11. The issue I have with bolusing in class is incase the person sat next to me can’t stand the sight of a needle and is needle phobic and with a pump I would be fine bolusing in class as there would be no needles for anyone to have a phobia about. With smaller doses it would be extremely helpful as depending on what the BG meter calculates the dose as it rounds it up or down to the nearest unit or half unit ( the meter is an Accuchek Aviva Expert)


You would be surprised what people have phobias about, I had a meeting with some teachers about running some science activities at the Uni I worked at and one of them said one of her students had a phobia about purple. I was renowned for always wearing purple, I still do.


----------



## Lily123

Leadinglights said:


> You would be surprised what people have phobias about, I had a meeting with some teachers about running some science activities at the Uni I worked at and one of them said one of her students had a phobia about purple. I was renowned for always wearing purple, I still do.


I mean I suppose she must have a reason for having a phobia about purple. I have a fear of clowns because of the film It


----------



## Bloden

Lily123 said:


> I mean I suppose she must have a reason for having a phobia about purple. I have a fear of clowns because of the film It


My husband can’t abide bananas - I thought he was kidding when he first told me and waved one in his face. He wasn’t a happy bunny. Who knows?

I was approved for a pump in September. I had NICE guidelines in the back of my mind and wasn’t sure I would fit the profile, except for my A1c which has been stuck at 8% for 10 years. The consultant said yes because 1. I need very small amounts of insulin, and 2. I’m very active and tend to go low really easily when I exercise (or just nip down the shops for milk...v annoying).

Good luck @Lily123!


----------



## Lily123

Bloden said:


> My husband can’t abide bananas - I thought he was kidding when he first told me and waved one in his face. He wasn’t a happy bunny. Who knows?
> 
> I was approved for a pump in September. I had NICE guidelines in the back of my mind and wasn’t sure I would fit the profile, except for my A1c which has been stuck at 8% for 10 years. The consultant said yes because 1. I need very small amounts of insulin, and 2. I’m very active and tend to go low really easily when I exercise (or just nip down the shops for milk...v annoying).
> 
> Good luck @Lily123!


A fear of bananas seem fairly unique - I feel sorry for your husband as many people will think he’s kidding if he tells them


----------



## sg295

Hi all,

Can I just ask, is it imperative to meet the NICE criteria in order to get a pump or if you have other good reasons can they count as well?

I have heaps of reasons why I think a pump could benefit me, mainly to do with quality of life issues but not sure if these reasons in themselves would be good enough?

Other issue is being fairly new to this, I’m not sure if I will be taken very seriously but things have changed since being diagnosed, most notably my career and the immense (and I mean immense!) difficulties surrounding that r.e diabetes management, as well as many other things so I’m not sure if that’s good enough or not? 

Thank you!


----------



## Lily123

I just asked my mum about insulin pumps and I showed her the list I put together - she told me that  when I was first diagnosed they asked about insulin pumps and was denied one because I had too good control over my numbers. But 6 years on there’s no harm in asking again right?


----------



## Lily123

sg295 said:


> Hi all,
> 
> Can I just ask, is it imperative to meet the NICE criteria in order to get a pump or if you have other good reasons can they count as well?
> 
> I have heaps of reasons why I think a pump could benefit me, mainly to do with quality of life issues but not sure if these reasons in themselves would be good enough?
> 
> Other issue is being fairly new to this, I’m not sure if I will be taken very seriously but things have changed since being diagnosed, most notably my career and the immense (and I mean immense!) difficulties surrounding that r.e diabetes management, as well as many other things so I’m not sure if that’s good enough or not?
> 
> Thank you!


You don’t have to meet the NiCE guidelines but if you meet the guidelines then you should get funding but if you don’t meet the guidelines then you have to have extremely good reasons to get a pump


----------



## sg295

Lily123 said:


> You don’t have to meet the NiCE guidelines but if you meet the guidelines then you should get funding but if you don’t meet the guidelines then you have to have extremely good reasons to get a pump


Ok great, thank you!

I’m not sure I meet the NICE guidelines that’s the issue but I do have a list of about 13 reasons why a pump could benefit me!

Guess I’d just have to present my list and hope for the best!


----------



## Lily123

sg295 said:


> Ok great, thank you!
> 
> I’m not sure I meet the NICE guidelines that’s the issue but I do have a list of about 13 reasons why a pump could benefit me!
> 
> Guess I’d just have to present my list and hope for the best!


If you put into the search bar “NICE guidelines for insulin pumps” it should take you too the NICE website and it will tell you the exact guidelines


----------



## sg295

Lily123 said:


> If you put into the search bar “NICE guidelines for insulin pumps” it should take you too the NICE website and it will tell you the exact guidelines


Ok brilliant, thanks for your help!


----------



## Bruce Stephens

sg295 said:


> Ok brilliant, thanks for your help!


Because I did it a few days ago:






						1 Guidance | Continuous subcutaneous insulin infusion for the treatment of diabetes mellitus | Guidance | NICE
					






					www.nice.org.uk


----------



## sg295

Bruce Stephens said:


> Because I did it a few days ago:
> 
> 
> 
> 
> 
> 
> 1 Guidance | Continuous subcutaneous insulin infusion for the treatment of diabetes mellitus | Guidance | NICE
> 
> 
> 
> 
> 
> 
> 
> www.nice.org.uk


Amazing thank you!


----------



## helli

@sg295 i think you mentioned you are new to diabetes - welcome to the club.

As I mentioned above, I really like my pump.
BUT it can go wrong. It never goes wrong at a convenient time. Whilst it is rare, it is stressful and I have to be ready to manage it at any time.
Therefore, I was really glad I injected for so long that it is still second nature to me when I need it.
Unless you have a strong reason for pumping (e.g young children need smaller doses than possible when injecting), I recommend sticking with injections for a year or two so you do not panic when your pump fails and not jumping into pumping straight away.


----------



## Inka

I agree with @helli and I’d also stress again that pumping is just another insulin delivery system. It can be a pain in the bottom like injections, and it’s most definitely not a magic answer. It’s still possible to get poor results with a pump because it depends on its user’s knowledge and experience. Unless you loop, it’s not automatic and you need to be pretty involved with managing it, as well as confident in how to deal with problems. Pump users run a higher risk of DKA.


----------



## Lily123

helli said:


> @sg295 i think you mentioned you are new to diabetes - welcome to the club.
> 
> As I mentioned above, I really like my pump.
> BUT it can go wrong. It never goes wrong at a convenient time. Whilst it is rare, it is stressful and I have to be ready to manage it at any time.
> Therefore, I was really glad I injected for so long that it is still second nature to me when I need it.
> Unless you have a strong reason for pumping (e.g young children need smaller doses than possible when injecting), I recommend sticking with injections for a year or two so you do not panic when your pump fails and not jumping into pumping straight away.


@helli incase the pump fails (If i get one) would I just need to carry round an insulin pen and needles in my school bag like I do now?


----------



## Bruce Stephens

helli said:


> Therefore, I was really glad I injected for so long that it is still second nature to me when I need it.


I worry about that kind of thing too (I don't use a pump). I felt lost when I was without Libre sensors for a week or two even though I had test strips (and once upon a time survived with just the useless urine test tape).

That'll be even worse when closed loops become much more common (which they absolutely should and I'd really like one). (I don't have a solution. It's just something that needs some consideration.)


----------



## helli

Lily123 said:


> @helli incase the pump fails (If i get one) would I just need to carry round an insulin pen and needles in my school bag like I do now?


There are a few options
- typically, the problem is something like an occlusion (blockage) so you just need to change the cannula.
- if I am out for a few hours, I carry a syringe which I can fill from my pump. This is smaller and easier to carry than pens and doesn’t  require me to take a pen cartridge out of the fridge and them throw it away unused a few weeks later.
- if I go away overnight, I take my pens for backup.


----------



## Inka

Lily123 said:


> @helli incase the pump fails (If i get one) would I just need to carry round an insulin pen and needles in my school bag like I do now?



I’ve never had a pump fail. What usually happens is some issue with the cannula eg an occlusion alert, or an obvious sign that your site isn’t working (high blood sugar). The pumps have a variety of alerts and alarms.

So, in the above instance, I’d replace my cannula. Remember the pump provides both basal and bolus, and because there is no long-acting insulin blood sugar can rise quickly. If you were to inject basal from a pen, you’d mess up the pump profile and could potentially be at risk of hypos later.


----------



## Lily123

helli said:


> There are a few options
> - typically, the problem is something like an occlusion (blockage) so you just need to change the cannula.
> - if I am out for a few hours, I carry a syringe which I can fill from my pump. This is smaller and easier to carry than pens and doesn’t  require me to take a pen cartridge out of the fridge and them throw it away unused a few weeks later.
> - if I go away overnight, I take my pens for backup.


I think I would prefer to carry a pen as it is more normal to me rather than carrying a syringe that I would need to fill from the pump. I think It would be a waste of the cartridge in the pen but (if I get a pump) during the first few weeks I would most likely get a few cannulas fail anyway


----------



## Inka

Lily123 said:


> I think I would prefer to carry a pen as it is more normal to me rather than carrying a syringe that I would need to fill from the pump. I think It would be a waste of the cartridge in the pen but (if I get a pump) during the first few weeks I would most likely get a few cannulas fail anyway



Not necessarily  I don’t remember having any cannula issues early on. They’ve all occurred over time. It’s not usually the user’s fault, just a ‘bad’ site - ie one that doesn’t work properly. The sets and cannulas are the absolute weak point of pumps as it’s them that usually cause problems. I really wish there was a way to sort that problem!


----------



## helli

Lily123 said:


> I think I would prefer to carry a pen as it is more normal to me rather than carrying a syringe that I would need to fill from the pump. I think It would be a waste of the cartridge in the pen but (if I get a pump) during the first few weeks I would most likely get a few cannulas fail anyway


Cannula fails are rare. I think I experienced one such failure in 4 years with my tubey pump.
If you get one, it better to change your cannula rather than starting pens as you will need basal so will have to start Tresiba in the middle of the day and be aware of Tresiba for the next 3 days when you restart the pump.

This is one of the many things you need to manage with a pump. As i said, it is not easy. But worth it.


----------



## Lily123

Inka said:


> Not necessarily  I don’t remember having any cannula issues early on. They’ve all occurred over time. It’s not usually the user’s fault, just a ‘bad’ site - ie one that doesn’t work properly. The sets and cannulas are the absolute weak point of pumps as it’s them that usually cause problems. I really wish there was a way to sort that problem!


So I would just need to carry a spear cannula? It turns out my parents asked the diabetes team about insulin pumps when I was recently diagnosed and the team said no because I had too good control over my numbers


----------



## Inka

Lily123 said:


> So I would just need to carry a spear cannula? It turns out my parents asked the diabetes team about insulin pumps when I was recently diagnosed and the team said no because I had too good control over my numbers



Yes, I carry a couple of spare sets and cannulas. They come in sterile packs around the size of a pack of playing cards but thinner. I slip one or two in my bag. If I’m away, I also put a spare battery in too.


----------



## Lily123

The libre seems to tell more about my control than my HbA1C. This is what my basal did this morning


----------



## Inka

The Libre graphs might be useful in your pump quest @Lily123 You can use them as evidence of what you’re describing.


----------



## Lily123

Inka said:


> The Libre graphs might be useful in your pump quest @Lily123 You can use them as evidence of what you’re describing.


You’re right the Libre graphs might be helpful. Although the basal would have caused my numbers to slowly drop overnight as I didn’t do a correction that would still be influencing my numbers that many hours on


----------



## Pattidevans

Inka said:


> Yes, I carry a couple of spare sets and cannulas. They come in sterile packs around the size of a pack of playing cards but thinner. I slip one or two in my bag. If I’m away, I also put a spare battery in too.


The cannulas for my pump come in huge blister packs.  Very hard to carry in a handbag.  If I am only going somewhere I can get home easily I don't carry one.  However going on holiday they fill my cabin baggage (with al the other diabetic trankenalia I carry on holiday).  When I worked I kept a spare in the office.  They are normally inserted with an applicator, but I have done it by hand before.  TBH I have only had  1 cannula failure when away from home locally and I just went home and changed it.   It's a moot point anyway as they are no longer offering the Combo.  In total I think I have only had 2 in 8 years fail.


----------



## Lily123

Pattidevans said:


> The cannulas for my pump come in huge blister packs.  Very hard to carry in a handbag.  If I am only going somewhere I can get home easily I don't carry one.  However going on holiday they fill my cabin baggage (with al the other diabetic trankenalia I carry on holiday).  When I worked I kept a spare in the office.  They are normally inserted with an applicator, but I have done it by hand before.  TBH I have only had  1 cannula failure when away from home locally and I just went home and changed it.   It's a moot point anyway as they are no longer offering the Combo.  In total I think I have only had 2 in 8 years fail.


This is making me gain so much confidence in pumps! I might get told no by the diabetes team tho. Only having 2 cannulas in 8 years fail seems to be that they don’t occur that often.I’d have to carry a spare cannula with me because school is a 30 minute walk from home


----------



## Inka

Interesting @Pattidevans I didn’t realise some came in big packs. I always insert mine by hand so don’t need an inserter. One less thing to carry!

Perhaps “fail” is the wrong word? None of my cannulas have broken or blocked, although one or two have become filled with blood so I changed them. It’s more about ‘bad’ sites for me. In those cases, I’d say the cannula had ‘failed’ - ie failed to work properly rather than suffered some internal failure. That’s what I meant by them being ‘the weakest link’. My Dana sets are fabulous but still a bad site can mess things up. If only there was a way to ensure insulin delivery 100%. Pumps will never be perfect for that reason. This only became really apparent to me after some years.


----------



## Lily123

Inka said:


> Interesting @Pattidevans I didn’t realise some came in big packs. I always insert mine by hand so don’t need an inserter. One less thing to carry!
> 
> Perhaps “fail” is the wrong word? None of my cannulas have broken or blocked, although one or two have become filled with blood so I changed them. It’s more about ‘bad’ sites for me. In those cases, I’d say the cannula had ‘failed’ - ie failed to work properly rather than suffered some internal failure. That’s what I meant by them being ‘the weakest link’. My Dana sets are fabulous but still a bad site can mess things up. If only there was a way to ensure insulin delivery 100%. Pumps will never be perfect for that reason. This only became really apparent to me after some years.


Maybe the way cannulas can go wrong varies depending on the make of the pump?


----------



## Pattidevans

Inka, the combo cannulas I use come in blister packs 7.3cm x 7.3cm x 5cm high.

I agree though, it could be all sorts... I have once taken off a cannula to find the filament bent at 45% half way down it's length.   On the other hand a bad site can be a slow fail.... once a cannula fell off in the night (I was in a very hot climate and no aircon, so I guess sweat had  something to do with that) and also sometimes insulin goes off.  It can be a bit of a guessing game at times.  Of course insulin going off can happen with injections as well.


Lily123 said:


> Maybe the way cannulas can go wrong varies depending on the make of the pump?


I don't think you can say that Lily.  Most pumps have more than one type of cannula and what suits one person may not suit another though.


----------



## Lily123

Pattidevans said:


> Inka, the combo cannulas I use come in blister packs 7.3cm x 7.3cm x 5cm high.
> 
> I agree though, it could be all sorts... I have once taken off a cannula to find the filament bent at 45% half way down it's length.   On the other hand a bad site can be a slow fail.... once a cannula fell off in the night (I was in a very hot climate and no aircon, so I guess sweat had  something to do with that) and also sometimes insulin goes off.  It can be a bit of a guessing game at times.  Of course insulin going off can happen with injections as well.
> 
> I don't think you can say that Lily.  Most pumps have more than one type of cannula and what suits one person may not suit another though.


Sorry I have done my research on pumps but not done my research that much on cannulas


----------



## Inka

Lily123 said:


> Maybe the way cannulas can go wrong varies depending on the make of the pump?



No, they’re all very similar, just some are better quality than others. The ones with my Dana pump are excellent.

The fault really is the way cannulas interact with the body. It also depends on a person’s body composition. There are different cannula lengths, different insert angles (some straight in, some angled), some are Teflon, some are steel - but they all have the potentially to ‘fail’ and cause high blood sugar.

I hate having high blood sugar so I try to replace dodgy cannulas earlier rather than later. I’ve used a pump for 18 years. As I said, the weak point is the cannulas as perfect delivery can’t be guaranteed. Therefore the cleverest, smartest, nicest pump still has the potential for a silly little bit of Teflon or steel to mess things up. That’s why they’re ‘the weakest link’ and it’s what will be a big problem when looping becomes more available. The Dana cannulas are the best I’ve had, but even then they’re not infallible. If someone could invent a way to infuse the insulin that was perfect, then that would be amazing because it would make a big difference.

To be clear, cannulas don’t usually ‘fail’ by breaking or malfunctioning. They fail at the intersection with the body.


----------



## Inka

Lily123 said:


> Sorry I have done my research on pumps but not done my research that much on cannulas



The cannulas are critical. Everyone goes on about all the great features of pumps blah blah, but it’s all pointless if the cannulas are poor quality or you have a poor choice of cannula types. Look closely at the range of cannulas for each pump, and Google for issues with them too. 

I use different cannula types for different body areas, and that’s not uncommon.


----------



## Lily123

Inka said:


> No, they’re all very similar, just some are better quality than others. The ones with my Dana pump are excellent.
> 
> The fault really is the way cannulas interact with the body. It also depends on a person’s body composition. There are different cannula lengths, different insert angles (some straight in, some angled), some are Teflon, some are steel - but they all have the potentially to ‘fail’ and cause high blood sugar.
> 
> I hate having high blood sugar so I try to replace dodgy cannulas earlier rather than later. I’ve used a pump for 18 years. As I said, the weak point in the cannulas as perfect delivery can’t be guaranteed. Therefore the cleverest, smartest, nicest pump still has the potential for a silly little bit of Teflon or steel to mess things up. That’s why they’re ‘the weakest link’ and it’s what will be a big problem when looping becomes more available. The Dana cannulas are the best I’ve had, but even then they’re not infallible. If someone could invent a way to infuse the insulin that was perfect, then that would be amazing because it would make a big difference.
> 
> To be clear, cannulas don’t usually ‘fail’ by breaking or malfunctioning. They fail at the intersection with the body.


So they go wrong through the insulin getting blocked or something like that?


----------



## Lily123

Inka said:


> The cannulas are critical. Everyone goes on about all the great features of pumps blah blah, but it’s all pointless if the cannulas are poor quality or you have a poor choice of cannula types. Look closely at the range of cannulas for each pump, and Google for issues with them too.
> 
> I use different cannula types for different body areas, and that’s not uncommon.


I will go and research cannulas. Although my parents asked about a pump when I was recently diagnosed and they said I had to good control for a pump but it won’t hurt to ask as it’s been 6 years


----------



## Inka

Lily123 said:


> So they go wrong through the insulin getting blocked or something like that?



They don’t work properly. Occasionally they get blocked, but often it’s to do with the body area they’re in. Absorption might be poor, or the area might get inflamed, etc. You can see that when you randomly get high sugar. Because you have no long-acting basal insulin with a pump, any mess up in the insulin delivery can cause blood sugar to rise quickly. Sometimes the cannula can get slightly bent or kinked and that interferes with delivery too.


----------



## Inka

Lily123 said:


> I will go and research cannulas. Although my parents asked about a pump when I was recently diagnosed and they said I had to good control for a pump but it won’t hurt to ask as it’s been 6 years



It’s always worth re-examining things over the years  Managing Type 1 is an ongoing process. Things can change, our preferences can change. It’s good to stop and see if you need or want changes


----------



## Lily123

Inka said:


> They don’t work properly. Occasionally they get blocked, but often it’s to do with the body area they’re in. Absorption might be poor, or the area might get inflamed, etc. You can see that when you randomly get high sugar. Because you have no long-acting basal insulin with a pump, any mess up in the insulin delivery can cause blood sugar to rise quickly. Sometimes the cannula can get slightly bent or kinked and that interferes with delivery too.


So if you over use the area the cannula is in and that body area could become lumpy and stop the insulin working properly? Like with MDI?


----------



## Lily123

Inka said:


> They don’t work properly. Occasionally they get blocked, but often it’s to do with the body area they’re in. Absorption might be poor, or the area might get inflamed, etc. You can see that when you randomly get high sugar. Because you have no long-acting basal insulin with a pump, any mess up in the insulin delivery can cause blood sugar to rise quickly. Sometimes the cannula can get slightly bent or kinked and that interferes with delivery too.


What does the degree bit mean? (Sorry but kinda confused)


----------



## Inka

Lily123 said:


> So if you over use the area the cannula is in and that body area could become lumpy and stop the insulin working properly? Like with MDI?



Similar - sometimes the area has simply become overused (remember the pump cannula sits in the same place for 3 days infusing insulin) but sometimes the way the fat is distributed under the skin causes poor absorption even in an area that’s _not_ been used a lot. As an example, I can hardly use my tummy for cannulas because of the composition of the skin/fat there. The absorption varies a lot and quite randomly too, which is stressful. However, if I use an insulin pen to bolus, I can inject in my tummy and the insulin will work.

It seems some areas are more fussy with cannulas. It can also depend on where your muscles are underneath. I like using my thigh for cannulas and it’s my best place, but others can hardly use their thighs at all, yet they can inject in them.


----------



## Inka

Lily123 said:


> What does the degree bit mean? (Sorry but kinda confused)



No need to apologise  Which bit did you mean?


----------



## Pumper_Sue

Lily123 said:


> Maybe the way cannulas can go wrong varies depending on the make of the pump?


Very much so, I used to have an Animas pump and a Cozmo before that and never any problems. Medtronic is a different matter though, putting it politely their consumables leave a lot to be desired.


----------



## Lily123

Inka said:


> No need to apologise  Which bit did you mean?


Where it says - 90-degree soft cannula. I’m on the Tandem website looking at the Tslim if thats any help


----------



## Pumper_Sue

Lily123 said:


> So they go wrong through the insulin getting blocked or something like that?


Sometimes they just kink on insertion hence no insulin gets through or sometimes they will come out/off if the stick comes unstuck.


----------



## Inka

Lily123 said:


> Where it says - 90-degree soft cannula. I’m on the Tandem website looking at the Tslim if thats any help



Ah - it means the cannula goes straight in (ie at 90 degrees to your skin). I guess the ‘soft’ bit means it’s Teflon (plastic) rather than steel like a pen needle. 

Some cannulas are angled not straight in, and they go in at 30 degrees or 45% degrees.


----------



## Lily123

Inka said:


> Ah - it means the cannula goes straight in (ie at 90 degrees to your skin). I guess the ‘soft’ bit means it’s Teflon (plastic) rather than steel like a pen needle.
> 
> Some cannulas are angled not straight in, and they go in at 30 degrees or 45% degrees.


Ah, that makes sense


----------



## Lily123

Pumper_Sue said:


> Sometimes they just kink on insertion hence no insulin gets through or sometimes they will come out/off if the stick comes unstuck.


Thanks - the amount of things that could go wrong had started to put me off a bit but then again the positives outweigh the negatives.


----------



## Inka

Lily123 said:


> Ah, that makes sense



The soft Teflon cannulas use an introducer needle. You insert them then withdraw the needle and it leaves behind the tiny Teflon cannula tube.


----------



## Lily123

My next appointment is the 16th of February


----------



## Lily123

Inka said:


> The soft Teflon cannulas use an introducer needle. You insert them then withdraw the needle and it leaves behind the tiny Teflon cannula tube.


That seems better than using a steel cannula


----------



## Inka

Lily123 said:


> That seems better than using a steel cannula



It is. I prefer the Teflon ones personally. But for some body areas, I do need the steel needle to get good absorption so I put up with the needle to get better numbers  It doesn’t hurt.

The cannulas come in different lengths eg my steel cannulas are 6mm, so it’s only a short needle. My Teflon ones are 6mm too. The angled ones I use are Teflon but are longer because they’re going in at an angle.


----------



## Lily123

Inka said:


> It is. I prefer the Teflon ones personally. But for some body areas, I do need the steel needle to get good absorption so I put up with the needle to get better numbers
> 
> The cannulas come in different lengths eg my steel cannulas are 6mm, so it’s only a short needle. My Teflon ones are 6mm too. The angled ones I use are Teflon but are longer because they’re going in at an angle.


So the cannulas are only slightly bigger than a needle? (the needles I use are 4mm)


----------



## Inka

Lily123 said:


> So the cannulas are only slightly bigger than a needle? (the needles I use are 4mm)



Yes


----------



## Lily123

Inka said:


> Yes


Now I know much more about cannulas - now when I’m looking at cannulas for different pumps I will know what the words mean. I will be back if I have any more questions. Thanks @Inka


----------



## Bruce Stephens

Pumper_Sue said:


> I used to have an Animas pump and a Cozmo before that and never any problems. Medtronic is a different matter though, putting it politely their consumables leave a lot to be desired.


And these things are specific to each pump (or pump manufacturer)? So it's not like pen needles (where a pen user can choose from a bunch of needle manufacturers)? Is there some technical reason why that's so, or is it just that nobody's standardised the interface (because manufacturers rather like this kind of incompatibility, typically)?


----------



## Lily123

Bruce Stephens said:


> And these things are specific to each pump (or pump manufacturer)? So it's not like pen needles (where a pen user can choose from a bunch of needle manufacturers)? Is there some technical reason why that's so, or is it just that nobody's standardised the interface (because manufacturers rather like this kind of incompatibility, typically)?


Maybe it depends on certain cannulas that are able to work with certain pumps? Or maybe it’s that if you have say a DANA RS pump and are using Tandem cannulas and they don’t work then who would you complain to?


----------



## helli

Bruce Stephens said:


> And these things are specific to each pump (or pump manufacturer)? So it's not like pen needles (where a pen user can choose from a bunch of needle manufacturers)? Is there some technical reason why that's so, or is it just that nobody's standardised the interface (because manufacturers rather like this kind of incompatibility, typically)?


i thought there were some crossovers. 
My tubey pump was an Animas which could use Medtronic cannulas. Animas is no longer available and I use a patch (tubeless, more discrete) pump so not familiar with the options for tubes.


----------



## Lily123

And I had strong hopes that by adjusting the dinner insulin to carb ratio I had fixed the issue with spikes at night

I did a correction at about 22:15 (I did the correction from the BG meter)


----------



## Lily123

I found the list of insulin pumps for the CCG - I believe it’s up to date. The appointment is next Tuesday so that’s when I’ll be asking about the possibility of a pump

The pumps are:
Ypsopump
Dana RS
Tandem Tslim
Medtronic
Omnipod Dash.
(I wouldn’t go for the Omnipod)

I’ve done my research on all these pumps and there cannulas but can anyone tell me the positives and negatives of any of these pumps?


----------



## Inka

I have a Dana RS pump and I’m very happy with it @Lily123 It holds 300 units but is tiny (at the time I got it, I believe it was the smallest/lightest 300 unit pump). Importantly for me, it can also be controlled by my phone, meaning I can bolus, adjust basal rates, etc, all without getting my pump out. It also has a very good selection of high quality cannulas and sets, including a nifty rotating one. I’d also say it’s really important to have good and reliable customer service. People often forget that. Dana has excellent customer service.

The Dana RS can be looped with an official app, or can be used with Open APS for a DIY loop. It was developed with looping in mind, but is excellent as a standalone pump. I haven’t found any negatives with it.

Your pros and cons might be different. Narrow it down to two or three pumps, then to two. Once you’ve got two, do a comparison and you should have a good idea of which feels right. For me, I’d never have a patch or pod pump so I ruled those out. I was left with 3, but was able to eliminate one immediately, and then spent lots of time deciding which was best.


----------



## Inka

Oh, and if you’re as sad as me, the DANA comes in different colours


----------



## Lily123

Inka said:


> I have a Dana RS pump and I’m very happy with it @Lily123 It holds 300 units but is tiny (at the time I got it, I believe it was the smallest/lightest 300 unit pump). Importantly for me, it can also be controlled by my phone, meaning I can bolus, adjust basal rates, etc, all without getting my pump out. It also has a very good selection of high quality cannulas and sets, including a nifty rotating one. I’d also say it’s really important to have good and reliable customer service. People often forget that. Dana has excellent customer service.
> 
> The Dana RS can be looped with an official app, or can be used with Open APS for a DIY loop. It was developed with looping in mind, but is excellent as a standalone pump. I haven’t found any negatives with it.
> 
> Your pros and cons might be different. Narrow it down to two or three pumps, then to two. Once you’ve got two, do a comparison and you should have a good idea of which feels right. For me, I’d never have a patch or pod pump so I ruled those out. I was left with 3, but was able to eliminate one immediately, and then spent lots of time deciding which was best.


This is extremely helpful to know! 300 units would definitely be more than enough for 3 days for me. I wouldn’t want a patch or pod pump as they look a bit on the bulky side


----------



## Lily123

Inka said:


> Oh, and if you’re as sad as me, the DANA comes in different colours


That’s not sad. I will go for black if I choose the DANA. I haven’t even asked my team about fuding for a pump yet


----------



## Sally71

My daughter has the Tandem T-slim.  Nice neat little pump, it will link with Dexcom G6 sensors and automatically make basal adjustments to try to keep your blood sugar in range.  Doesn’t work perfectly (if you are dropping fast for example it won’t be able to react quickly enough to stop you going hypo) but it definitely helps!  Very few people get Dexcom sensors on the NHS though and they aren’t cheap.  I personally think the refill procedure is a bit fiddly, although we only have the Accu-Chek Combo to compare with which isn’t even available any more, and daughter seems happy with it.  It isn’t remote control though, you have to do everything on the pump itself, nice colour touch screen but you need the pump to be accessible not hidden under your clothes.  You can download an emulator for the t-slim software and play with it on your phone to see how it works!  It will also work as a standalone pump if you don’t want or can’t get the sensors.


----------



## Lily123

Sally71 said:


> My daughter has the Tandem T-slim.  Nice neat little pump, it will link with Dexcom G6 sensors and automatically make basal adjustments to try to keep your blood sugar in range.  Doesn’t work perfectly (if you are dropping fast for example it won’t be able to react quickly enough to stop you going hypo) but it definitely helps!  Very few people get Dexcom sensors on the NHS though and they aren’t cheap.  I personally think the refill procedure is a bit fiddly, although we only have the Accu-Chek Combo to compare with which isn’t even available any more, and daughter seems happy with it.  It isn’t remote control though, you have to do everything on the pump itself, nice colour touch screen but you need the pump to be accessible not hidden under your clothes.  You can download an emulator for the t-slim software and play with it on your phone to see how it works!  It will also work as a standalone pump if you don’t want or can’t get the sensors.


I don’t think I’d meet the criteria for Dexcom and my parents couldn’t fund them for me as they are really expensive. I’ll have a look at the simulator app. I’m asking about an insulin pump on either Tuesday or Wednesday - although there’s every chance that the diabetes team will say no


----------



## Lily123

Inka said:


> I have a Dana RS pump and I’m very happy with it @Lily123 It holds 300 units but is tiny (at the time I got it, I believe it was the smallest/lightest 300 unit pump). Importantly for me, it can also be controlled by my phone, meaning I can bolus, adjust basal rates, etc, all without getting my pump out. It also has a very good selection of high quality cannulas and sets, including a nifty rotating one. I’d also say it’s really important to have good and reliable customer service. People often forget that. Dana has excellent customer service.
> 
> The Dana RS can be looped with an official app, or can be used with Open APS for a DIY loop. It was developed with looping in mind, but is excellent as a standalone pump. I haven’t found any negatives with it.
> 
> Your pros and cons might be different. Narrow it down to two or three pumps, then to two. Once you’ve got two, do a comparison and you should have a good idea of which feels right. For me, I’d never have a patch or pod pump so I ruled those out. I was left with 3, but was able to eliminate one immediately, and then spent lots of time deciding which was best.


@Inka is the DANA waterproof? I haven’t been able to find out if it is or not


----------



## Inka

Lily123 said:


> @Inka is the DANA waterproof? I haven’t been able to find out if it is or not



I believe it is, yes. I’ve never used in in water so I can’t swear 100% it is, but I’m pretty sure I was told it was at my training, and online sites say it is too.

 I use the rotating O sets and it’s so easy to click off for a shower (the cannula has a self-seal membrane so you don’t have to worry about putting a cap on it when it’s in your body). When I swim, I just take it off as I don’t need insulin then and often have some carbs.

Because I control it from my phone, I never have to take it out apart from changes so I wear it in a Hid-In soft belt round my waist under my clothes. It’s safe, dry and I don’t even notice it. It weighs 62g with a full 300 units of insulin in so is very light. It’s light but robust, which is something that appealed to me. I’ve had it almost 3 years and it looks the same as the day I had it. A previous pump was more plasticky and looked quite worn by this stage.


----------



## Lily123

Inka said:


> I believe it is, yes. I’ve never used in in water so I can’t swear 100% it is, but I’m pretty sure I was told it was at my training, and online sites say it is too.
> 
> I use the rotating O sets and it’s so easy to click off for a shower (the cannula has a self-seal membrane so you don’t have to worry about putting a cap on it when it’s in your body). When I swim, I just take it off as I don’t need insulin then and often have some carbs.
> 
> Because I control it from my phone, I never have to take it out apart from changes so I wear it in a Hid-In soft belt round my waist under my clothes. It’s safe, dry and I don’t even notice it. It weighs 62g with a full 300 units of insulin in so is very light. It’s light but robust, which is something that appealed to me. I’ve had it almost 3 years and it looks the same as the day I had it. A previous pump was more plasticky and looked quite worn by this stage.


I’d have to find out how much water it could withstand because taking it off for swimming seems very complicated. It would probable become second nature just like injections are on MDI but I’m not sure. I’ll let you know the diabetes teams response from me asking about a pump


----------



## Inka

It’s not complicated at all! It takes seconds  You just click it off your pump site (cannula). Then to re-connect it you click it on. It’s similar to doing up a press-stud and takes a second or two.


----------



## Lily123

Ah, that makes it sound really easy. Are the cannula changes complicated?


----------



## Inka

Lily123 said:


> Ah, that makes it sound really easy. Are the cannula changes complicated?



No, they’re easy. Obviously the first few times you go slowly because you’re getting used to it, but it’s easy. All the cannulas have inserters, but I just do it by hand. 

You open the sterile pack, take out the cannula bit, peel off the backing paper, stick it in you, withdraw the little needle bit (like a pen needle) and it leaves behind a tiny little Teflon tube. Then you click the bit on the end of the pump tube in to this.That’s a very basic description but you get the idea. 

So to disconnect, you just click off the bit on the end of the pump tube. It’s like clicking two halves of plastic together that are made to fit perfectly when you put it back on. It’s not technical.


----------



## Lily123

Inka said:


> No, they’re easy. Obviously the first few times you go slowly because you’re getting used to it, but it’s easy. All the cannulas have inserters, but I just do it by hand.
> 
> You open the sterile pack, take out the cannula bit, peel off the backing paper, stick it in you, withdraw the little needle bit (like a pen needle) and it leaves behind a tiny little Teflon tube. Then you click the bit on the end of the pump tube in to this.That’s a very basic description but you get the idea.
> 
> So to disconnect, you just click off the bit on the end of the pump tube. It’s like clicking two halves of plastic together that are made to fit perfectly when you put it back on. It’s not technical.


That makes sense! Thanks


----------



## SB2015

Hi @Lily123 I use a Medtronic 780G pump.  This can be used in manual mode without a sensor, or with their sensors, and in a closed loop system, so there are a variety of options. 

As with most pumps there are a variety of options of cannulas,  metal or Teflon (I have always gone for Teflon after one week of metal ones) , a choice of lengths (I have the shortest at 6mm) , and different lengths of tubing (I usually use 60 cm tubes which allows me to tuck my pump away in my bra and hook it out when I need to).  My pump is waterproof but I still disconnect it for my shower, which is very easy to do as I just separate the tube from the cannula, and plug it in again afterwards.  I have not yet swum with this one but I think I would still disconnect.

The main pros for my pump are 

Slow delivery of bolus insulin Available
I was getting skanky cannula sites on my old pump and this has overcome that
Option of using sensors in a closed loop system (which I have to self fund) with the pump checking my level every 5 min and adjusting my basal insulin
Cons for my pump

I have to get my pump out when I want to do a bolus
I didn’t have to on my old pump
Any questions that you have.  Just ask.


----------



## Lily123

SB2015 said:


> Hi @Lily123 I use a Medtronic 780G pump.  This can be used in manual mode without a sensor, or with their sensors, and in a closed loop system, so there are a variety of options.
> 
> As with most pumps there are a variety of options of cannulas,  metal or Teflon (I have always gone for Teflon after one week of metal ones) , a choice of lengths (I have the shortest at 6mm) , and different lengths of tubing (I usually use 60 cm tubes which allows me to tuck my pump away in my bra and hook it out when I need to).  My pump is waterproof but I still disconnect it for my shower, which is very easy to do as I just separate the tube from the cannula, and plug it in again afterwards.  I have not yet swum with this one but I think I would still disconnect.
> 
> The main pros for my pump are
> 
> Slow delivery of bolus insulin Available
> I was getting skanky cannula sites on my old pump and this has overcome that
> Option of using sensors in a closed loop system (which I have to self fund) with the pump checking my level every 5 min and adjusting my basal insulin
> Cons for my pump
> 
> I have to get my pump out when I want to do a bolus
> I didn’t have to on my old pump
> Any questions that you have.  Just ask.


This pump does sound ideal. I wouldn’t mind having to get the pump out to bolus because I would want long enough tubing to tuck it in a trouser or skirt or dress pocket.I would definitely want a pump that could loop in case the guidelines for prescribing the guardian sensors or dexcom sensors became more common. I haven’t even asked about a pump yet


----------



## Lily123

Sally71 said:


> My daughter has the Tandem T-slim.  Nice neat little pump, it will link with Dexcom G6 sensors and automatically make basal adjustments to try to keep your blood sugar in range.  Doesn’t work perfectly (if you are dropping fast for example it won’t be able to react quickly enough to stop you going hypo) but it definitely helps!  Very few people get Dexcom sensors on the NHS though and they aren’t cheap.  I personally think the refill procedure is a bit fiddly, although we only have the Accu-Chek Combo to compare with which isn’t even available any more, and daughter seems happy with it.  It isn’t remote control though, you have to do everything on the pump itself, nice colour touch screen but you need the pump to be accessible not hidden under your clothes.  You can download an emulator for the t-slim software and play with it on your phone to see how it works!  It will also work as a standalone pump if you don’t want or can’t get the sensors.


One thing I want to ask about Dexcom - do the Dexcom sensors get compression lows like Libre? If so how does this work with Basal IQ and Control IQ?


----------



## SB2015

Lily123 said:


> This pump does sound ideal. I wouldn’t mind having to get the pump out to bolus because I would want long enough tubing to tuck it in a trouser or skirt or dress pocket.I would definitely want a pump that could loop in case the guidelines for prescribing the guardian sensors or dexcom sensors became more common. I haven’t even asked about a pump yet


The closed loop works very well for me with me getting TIR of around 85%.  I also get a lot more sleep.
I don’t seem to get compression lows, and if the pump sense that something isn’t quite right it will alarm and ask you to check.  Irritating but understandable.

The Medtronic sensors with the transmitter work out at about the same price as the Dexcom with the transmitter for T- Slim so not much to choose between them.

Any questions fire away.


----------



## SB2015

When you do get round to asking about the pumps you will be well prepared.
Sounds like a good plan.

I like @everydayupsanddowns comment ages ago when I was trying to choose.  It is only for four years and those pass so quickly And then there are a whole new lots to choose from next time.


----------



## Lily123

SB2015 said:


> The closed loop works very well for me with me getting TIR of around 85%.  I also get a lot more sleep.
> I don’t seem to get compression lows, and if the pump sense that something isn’t quite right it will alarm and ask you to check.  Irritating but understandable.
> 
> The Medtronic sensors with the transmitter work out at about the same price as the Dexcom with the transmitter for T- Slim so not much to choose between them.
> 
> Any questions fire away.


So the Medtronic sensors will pick up on any data it reads as unusual and ask you to double check with a finger prick?


----------



## SB2015

Like other pumps it will alert if you go high or low.I find that with the closed loop these are rare as the pump changes my basal before I get to that stage in general.  If I snack late I will see a rise and if I have got the carbs out a bit the pump sorts it out whilst I just sleep.

This pump also alerts me if it is giving a maximum basal for an extended period of time, same with minimum, and sometimes I am not sure why.  I had a couple sensors fail early so levels did not match and the pump advised me to change sensor (these have always been replaced).

The switch to closed loop has had the same positive impact as when I first started using a Libre.  I sleep more,I am in range a lot more and I think about my diabetes a lot less.  Just more relaxed.   I know that this is not accessible to all because of the cost, but who knows what will happen in the future.


----------



## Lily123

SB2015 said:


> Like other pumps it will alert if you go high or low.I find that with the closed loop these are rare as the pump changes my basal before I get to that stage in general.  If I snack late I will see a rise and if I have got the carbs out a bit the pump sorts it out whilst I just sleep.
> 
> This pump also alerts me if it is giving a maximum basal for an extended period of time, same with minimum, and sometimes I am not sure why.  I had a couple sensors fail early so levels did not match and the pump advised me to change sensor (these have always been replaced).
> 
> The switch to closed loop has had the same positive impact as when I first started using a Libre.  I sleep more,I am in range a lot more and I think about my diabetes a lot less.  Just more relaxed.   I know that this is not accessible to all because of the cost, but who knows what will happen in the future.


Extremely smart pumps and sensors. If I get approved for a pump I won’t be able to do closed loop but like you say who knows what could happen in the future


----------



## Proud to be erratic

Lily123 said:


> @Inka is the DANA waterproof? I haven’t been able to find out if it is or not


Hi @Lily123 , I've been following this discussion because I am keen to move onto a pump and your questions have been helpful for me. So thanks.

Regarding NovoEcho pens: I am about to change my Tresiba from disposable pens to cartridges and therefore need a new NovoEcho pen in a different colour. I currently have 2 blue pens for my NovoRapid bolus; these were provided by my GP's prescription automatically requesting 2 pens when I moved from disposable bolus pens to cartridges, one for daily use and one as a reserve in case the first pen failed. I didn't ask for 2 pens (but I did ask for blue). I live in Bucks and I checked with my pharmacy that our CCG approved Tresiba cartridges and then had a simple phone call with our local Surgery nurse who immediately agreed with the principle of making the change from disposable to cartridges and also immediately agreed to prescribe the extra NovoEcho pen - in red, to distinguish it from bolus. So what I thought might be a "struggle" was actually very straightforward. So I think you should have no difficulty in getting a replacement pen for your dodgy one, plus at least one new extra pen in a different colour. Currently my local pharmacy can only see 2 colours in their listings for NovoEcho pens, blue and red - but I don't know of that's because they are part of a chain of pharmacies and have their choices limited by the chain's HQ. 

Good luck for Wednesday for your consult and pump request.


----------



## Bruce Stephens

Proud to be erratic said:


> Currently my local pharmacy can only see 2 colours in their listings for NovoEcho pens, blue and red - but I don't know of that's because they are part of a chain of pharmacies and have their choices limited by the chain's HQ.


The pictures only show red and blue: https://www.novonordisk.com/our-products/pens-and-needles/novopen-echo.html


----------



## Lily123

Proud to be erratic said:


> Hi @Lily123 , I've been following this discussion because I am keen to move onto a pump and your questions have been helpful for me. So thanks.
> 
> Regarding NovoEcho pens: I am about to change my Tresiba from disposable pens to cartridges and therefore need a new NovoEcho pen in a different colour. I currently have 2 blue pens for my NovoRapid bolus; these were provided by my GP's prescription automatically requesting 2 pens when I moved from disposable bolus pens to cartridges, one for daily use and one as a reserve in case the first pen failed. I didn't ask for 2 pens (but I did ask for blue). I live in Bucks and I checked with my pharmacy that our CCG approved Tresiba cartridges and then had a simple phone call with our local Surgery nurse who immediately agreed with the principle of making the change from disposable to cartridges and also immediately agreed to prescribe the extra NovoEcho pen - in red, to distinguish it from bolus. So what I thought might be a "struggle" was actually very straightforward. So I think you should have no difficulty in getting a replacement pen for your dodgy one, plus at least one new extra pen in a different colour. Currently my local pharmacy can only see 2 colours in their listings for NovoEcho pens, blue and red - but I don't know of that's because they are part of a chain of pharmacies and have their choices limited by the chain's HQ.
> 
> Good luck for Wednesday for your consult and pump request.


I have my appointment on Wednesday so I will be asking about a pump and getting a different colour pen then. The pharmacy I get my prescription from is an independent one so not sure. I have a spare NovoPen Echo which is also blue but will ask about a different colour for basal as I’ve always had blue for bolus.When I was using Lantus I did use disposable pens for a while because I couldn’t press the end in on the Sanofi JuniorStar pen but the disposable pens were even worse!


----------



## Lily123

Benny G said:


> @Lily123, You can decorate your spare echo pen with stickers, velcro, or paint, or put a bell on it, whatever helps.
> For a while I used  2 silver novo 3 pens, with velcro for tactile identification.


Bolus is in a blue case and basal is in a black case but still I would prefer to be over cautious rather than risk doing 23 units of NovoRapid instead of Tresiba! Good idea I might do that


----------



## Lily123

Proud to be erratic said:


> Hi @Lily123 , I've been following this discussion because I am keen to move onto a pump and your questions have been helpful for me. So thanks.
> 
> Regarding NovoEcho pens: I am about to change my Tresiba from disposable pens to cartridges and therefore need a new NovoEcho pen in a different colour. I currently have 2 blue pens for my NovoRapid bolus; these were provided by my GP's prescription automatically requesting 2 pens when I moved from disposable bolus pens to cartridges, one for daily use and one as a reserve in case the first pen failed. I didn't ask for 2 pens (but I did ask for blue). I live in Bucks and I checked with my pharmacy that our CCG approved Tresiba cartridges and then had a simple phone call with our local Surgery nurse who immediately agreed with the principle of making the change from disposable to cartridges and also immediately agreed to prescribe the extra NovoEcho pen - in red, to distinguish it from bolus. So what I thought might be a "struggle" was actually very straightforward. So I think you should have no difficulty in getting a replacement pen for your dodgy one, plus at least one new extra pen in a different colour. Currently my local pharmacy can only see 2 colours in their listings for NovoEcho pens, blue and red - but I don't know of that's because they are part of a chain of pharmacies and have their choices limited by the chain's HQ.
> 
> Good luck for Wednesday for your consult and pump request.


Oh and should add - I live in Herts but am under Bucks CCG so the GP is in Herts and hospital in Bucks


----------



## Lily123

Good news! I had my appointment today and the diabetes team said that I should come to the pump and technology day in April! So it wasn’t a no


----------



## rebrascora

Excellent news! So pleased for you. A step in the right direction.


----------



## Lily123

Yes! And my HbA1C hasn’t changed!


----------



## rebrascora

Congrats on that too. Well done!


----------



## rayray119

That's good. I've been following this because im interested(still to afaird to a)i know people on here say its too toom. I do have reasons for wanting to try it.


----------



## Lily123

rebrascora said:


> Congrats on that too. Well done!


Thanks


rayray119 said:


> That's good. I've been following this because im interested(still to afaird to a)i know people on here say its too toom. I do have reasons for wanting to try it.


If there’s one thing I’ve leant from this forum, it’s don’t be afraid to ask as the worst your doctor can say is no!


----------



## rayray119

Lily123 said:


> Thanks
> 
> If there’s one thing I’ve leant from this forum, it’s don’t be afraid to ask as the worst your doctor can say is no!


Hmm yes I allready know if I did get one I would want a patch pump as there's a lucky tood i would catch tubed ones. I'm being referred to danfee.  My reasons are sometimes even the tinyest adjustment when things went working can sand things the other way. Im pretty sure my background needs are different for each time of day or night whichj you just can't do on pens. And my job.  However if they fail as much as my libre sensors did they might be a bit of a problem. Maybe by my next appointment ill have picked up the courage to at least ask about the possibility


----------



## Sally71

Lily123 said:


> One thing I want to ask about Dexcom - do the Dexcom sensors get compression lows like Libre? If so how does this work with Basal IQ and Control IQ?


Yes they can do, so then the pump would think you were having a hypo and switch the basal off.  But the worst that can happen is that you’re a bit high later and you correct it.  You’ll get alarms going off as well to alert you if it thinks you’re low so hopefully you’d realise the problem sooner rather than later!


----------



## Lily123

rayray119 said:


> Hmm yes I allready know if I did get one I would want a patch pump as there's a lucky tood i would catch tubed ones. I'm being referred to danfee.  My reasons are sometimes even the tinyest adjustment when things went working can sand things the other way. Im pretty sure my background needs are different for each time of day or night whichj you just can't do on pens. And my job.  However if they fail as much as my libre sensors did they might be a bit of a problem. Maybe by my next appointment ill have picked up the courage to at least ask about the possibility


You’d also need to find out what pumps your CCG offer as they may not offer the pump you want


----------



## Lily123

Sally71 said:


> Yes they can do, so then the pump would think you were having a hypo and switch the basal off.  But the worst that can happen is that you’re a bit high later and you correct it.  You’ll get alarms going off as well to alert you if it thinks you’re low so hopefully you’d realise the problem sooner rather than later!


That’s good that it alarms you


----------



## helli

Lily123 said:


> Good news! I had my appointment today and the diabetes team said that I should come to the pump and technology day in April! So it wasn’t a no


That's fantastic news. 
My recommendation would be to get to hold and feel all of the pumps on offer. 
You say you don't want a patch pump becaus eit is too bulky - that was the reason I pushed for a patch pump - the tubed ones are much bulkier


----------



## Lily123

helli said:


> That's fantastic news.
> My recommendation would be to get to hold and feel all of the pumps on offer.
> You say you don't want a patch pump becaus eit is too bulky - that was the reason I pushed for a patch pump - the tubed ones are much bulkier


I’m sure I’ll find out at the pump information day in April - whether it’s virtual or in person I don’t know


----------



## nonethewiser

Lily123 said:


> Good news! I had my appointment today and the diabetes team said that I should come to the pump and technology day in April! So it wasn’t a no



Good news, first step anyway. Regards patch pump being bulky, not so in fact forget sometimes I'm wearing one, only decided on omnipod as its tube free so less hassle.


----------



## Lily123

nonethewiser said:


> Good news, first step anyway. Regards patch pump being bulky, not so in fact forget sometimes I'm wearing one, only decided on omnipod as its tube free so less hassle.


This is changing my mind on which pump - I know that one of the pumps on offer is the Omnipod Dash


----------



## nonethewiser

Lily123 said:


> This is changing my mind on which pump - I know that one of the pumps on offer is the Omnipod Dash



Currently using it, switched over to it back in November. Only one fault so far, that is handset, find it needs charged most days or it goes flat quickly, so charge it at night when go to bed, apart from that's it's great, just looks like mobile phone.


----------



## Lily123

Benny G said:


> Well done @Lily123, keep pushing for that pump


Thanks


----------



## rayray119

Lily123 said:


> You’d also need to find out what pumps your CCG offer as they may not offer the pump you want


I know they offer the onipod because otherf people have it


----------



## Lily123

rayray119 said:


> I know they offer the onipod because otherf people have it


Ah, then you need to work up the courage to speak to your consultant. As others have said the worst your consultant can say is no and it won’t hurt to ask


----------



## helli

rayray119 said:


> Hmm yes I allready know if I did get one I would want a patch pump as there's a lucky tood i would catch tubed ones. I'm being referred to danfee.  My reasons are sometimes even the tinyest adjustment when things went working can sand things the other way. Im pretty sure my background needs are different for each time of day or night whichj you just can't do on pens. And my job.  However if they fail as much as my libre sensors did they might be a bit of a problem. Maybe by my next appointment ill have picked up the courage to at least ask about the possibility


DAFNE is often a pre-requisite for pumps and may be a great chance to get to know the people who can influence whether you will be considered for a pump or not. My local DAFNE course is run by one of the DSNs and a dietician. They want to see that you are the kind of  person who is willing and able to put in the effort needed to manage a pump.


----------



## rebrascora

helli said:


> DAFNE is often a pre-requisite for pumps and may be a great chance to get to know the people who can influence whether you will be considered for a pump or not. My local DAFNE course is run by one of the DSNs and a dietician. They want to see that you are the kind of  person who is willing and able to put in the effort needed to manage a pump.


Totally agree with this. The DSN who takes the DAFNE course may well advocate for you with the consultant if he/she feels that you will benefit from a pump. Several people from my course got a pump within a couple of months of attending the course. They get to know you and your diabetes pretty well when they spend a whole week with you, going over your daily readings and seeing what conclusions you can draw from them and what strategies you try to resolve them. It is a really great course because you learn from the other members of the group and the different problems they are facing (which you may well encounter in the future) as well as your own issues. I was really apprehensive about attending it  especially as I eat low carb but it was brilliant. So pleased you are being put forward for it @rayray119


----------



## rayray119

rebrascora said:


> Totally agree with this. The DSN who takes the DAFNE course may well advocate for you with the consultant if he/she feels that you will benefit from a pump. Several people from my course got a pump within a couple of months of attending the course. They get to know you and your diabetes pretty well when they spend a whole week with you, going over your daily readings and seeing what conclusions you can draw from them and what strategies you try to resolve them. It is a really great course because you learn from the other members of the group and the different problems they are facing (which you may well encounter in the future) as well as your own issues. I was really apprehensive about attending it  especially as I eat low carb but it was brilliant. So pleased you are being put forward for it @rayray119


Yes I asked about that yesterday im being referred to it


----------



## sg295

Glad the appointment went well @Lily123 

I have my consultant appointment next Wednesday and it honestly can’t come round quickly enough. The last few months have been a real struggle with so many issues that just seem to have no solution.

I’m super grateful they moved it a month early (I think they realised I was finding it all super hard as I sent a looooong email explaining all my issues!)

Just shows that if you push for something, you can often get the outcome you want in the end, including me getting this appointment early. Just hoping they will have some solutions for me


----------



## Lily123

sg295 said:


> Glad the appointment went well @Lily123
> 
> I have my consultant appointment next Wednesday and it honestly can’t come round quickly enough. The last few months have been a real struggle with so many issues that just seem to have no solution.
> 
> I’m super grateful they moved it a month early (I think they realised I was finding it all super hard as I sent a looooong email explaining all my issues!)
> 
> Just shows that if you push for something, you can often get the outcome you want in the end, including me getting this appointment early. Just hoping they will have some solutions for me


Good luck at your appointment! And if you're anything like me,write down a list of questions to ask the consultant in case your mind goes blank during the appointment


----------



## sg295

Lily123 said:


> Good luck at your appointment! And if you'll anything like me,write down a list of questions to ask the consultant in case your mind goes blank during the appointment


Thank you 

Yes I’ve been working on it, honestly have a list of about 20 things I need to discuss currently and there may well be more by next week!


----------



## rayray119

I don't even know why next consutdent apoiment is I just realised I've only spoken to 1 snice dianosgous


----------



## sg295

rayray119 said:


> I don't even know why next consutdent apoiment is I just realised I've only spoken to 1 snice dianosgous


How long ago were you diagnosed? I’m currently having an appointment every 6 months so this will be my second one since diagnosis as it’s been just under a year


----------



## rayray119

sg295 said:


> How long ago were you diagnosed? I’m currently having an appointment every 6 months so this will be my second one since diagnosis as it’s been just under a year


Sh 6 months on the 4th. So I can't speak to them earlier I did get a text saying I have a diabtic medice apoiment next week what ever that is.


----------



## Lily123

rayray119 said:


> Sh 6 months on the 4th. So I can't speak to them earlier I did get a text saying I have a diabtic medice apoiment next week what ever that is.


At the hospital? That will probably be when they can answer any questions you have and you could ask about a pump if you want


----------



## sg295

rayray119 said:


> Sh 6 months on the 4th. So I can't speak to them earlier I did get a text saying I have a diabtic medice apoiment next week what ever that is.


Ok so you were diagnosed in September? Do you have a designated diabetes specialist nurse (DSN) that you can talk to?

At my centre, there is a phone number that you can phone to discuss any issues day to day in between appointments if you’re having issues with particular things eg exercise, hypos, carb counting etc so you should have someone you can talk to in between.


----------



## rayray119

Lily123 said:


> At the hospital? That will probably be when they can answer any questions you have and you could ask about a pump if you want


I remember my friend said she brought her mum(aslo diabetic). They asked I unfounterty don't have anyone to do that. Example of the whole extra insulin thing was 8.6 when I at diner rounded 3.86 to 4 went down to 3.3 maybe I need some backroomd tests before I blame the insulin. Yeah day I was 8.somthing I think it was 8.8 and lunch think I rounded the 3.2 to 3 and I went to 10.something and stayed overcorected with my tea though and went to 4.3 though not correct a hypo that heanding there.   But struggling to be in range at the moment maybe it's my honeymoon I was going to an overnightbbasdl test tonight but the 3.3 has stopped thaf plan because cau


----------



## Lily123

rayray119 said:


> I remember my friend said she brought her mum(aslo diabetic). They asked I unfounterty don't have anyone to do that. Example of the whole extra insulin thing was 8.6 when I at diner rounded 3.86 to 4 went down to 3.3 maybe I need some backroomd tests before I blame the insulin. Yeah day I was 8.somthing I think it was 8.8 and lunch think I rounded the 3.2 to 3 and I went to 10.something and stayed overcorected with my tea though and went to 4.3 though not correct a hypo that heanding there.   But struggling to be in range at the moment maybe it's my honeymoon I was going to an overnightbbasdl test tonight but the 3.3 has stopped thaf plan because cau


It might be the honeymoon period or background insulin or you need very small doses of insulin. Whichever it is you should tell your consultant at your next appointment and also you could ask about the possibility of a pump - you might think you’ll get an immediate no (I though I would get an immediate no) but you never know!


----------



## sg295

rayray119 said:


> I remember my friend said she brought her mum(aslo diabetic). They asked I unfounterty don't have anyone to do that. Example of the whole extra insulin thing was 8.6 when I at diner rounded 3.86 to 4 went down to 3.3 maybe I need some backroomd tests before I blame the insulin. Yeah day I was 8.somthing I think it was 8.8 and lunch think I rounded the 3.2 to 3 and I went to 10.something and stayed overcorected with my tea though and went to 4.3 though not correct a hypo that heanding there.   But struggling to be in range at the moment maybe it's my honeymoon I was going to an overnightbbasdl test tonight but the 3.3 has stopped thaf plan because cau


I’m having similar issues currently. If I round it (which is the only option I have), it doesn’t seem to agree with me and it either sits there and doesn’t come down all that much or it sends me low.

That as well as having issues with exercising, certain foods and most importantly, my career being majorly impacted, just to name a few, are reasons why I got my appointment moved


----------



## rayray119

sg295 said:


> I’m having similar issues currently. If I round it (which is the only option I have), it doesn’t seem to agree with me and it either sits there and doesn’t come down all that much or it sends me low.
> 
> That as well as having issues with exercising, certain foods and most importantly, my career being majorly impacted, just to name a few, are reasons why I got my appointment moved


those are almost exactly the reasons I'm considering it.  i have an active job(I can't predict how active I'm going to be until I do the shift though) i know on pumps you can set temp basels(which i know will take some working out).  but to be able to get things more exact would be good.


----------



## rayray119

and the pumps will ask you to confirm bolus even my pens tell me what given myself its too late once I've done it. that's probelly not really a reason to go for a pump. but my other reasons are vaild


----------



## sg295

rayray119 said:


> those are almost exactly the reasons I'm considering it.  i have an active job(I can't predict how active I'm going to be until I do the shift though) i know on pumps you can set temp basels(which i know will take some working out).  but to be able to get things more exact would be good.


Yes I totally understand what you mean. I have a variable job, exercise is super unpredictable, certain foods completely mess me up as well! 

Pasta and sometimes rice are awful for me and I have tried everything! Suggested I tried split doses - it doesn’t work! I’ve tried various different intervals of 30 mins, 1 hour, 1.5 hours, 2 hours etc and none of them seem to work and I end up either having a hypo or missing the boat and going too high! 

I was then told to just do less insulin but this doesn’t work either as it doesn’t bring it down sufficiently so I have no idea what I’m supposed to do except not eat them…which majorly excludes me when I go for meals with people as we often go out to Indian and Italian restaurants!

Honestly at the moment I just feel like anything that could be an issue is an issue and that anything I try is not a solution, so frustrating!


----------



## rayray119

sg295 said:


> Yes I totally understand what you mean. I have a variable job, exercise is super unpredictable, certain foods completely mess me up as well!
> 
> Pasta and sometimes rice are awful for me and I have tried everything! Suggested I tried split doses - it doesn’t work! I’ve tried various different intervals of 30 mins, 1 hour, 1.5 hours, 2 hours etc and none of them seem to work and I end up either having a hypo or missing the boat and going too high!
> 
> I was then told to just do less insulin but this doesn’t work either as it doesn’t bring it down sufficiently so I have no idea what I’m supposed to do except not eat them…which majorly excludes me when I go for meals with people as we often go out to Indian and Italian restaurants!
> 
> Honestly at the moment I just feel like anything that could be an issue is an issue and that anything I try is not a solution, so frustrating!


plus the whole going off to inject as a steward is a bit awkward(when I work though the evening) and I half to find a disert place as it might look odd to cowrds.


----------



## Lily123

sg295 said:


> Yes I totally understand what you mean. I have a variable job, exercise is super unpredictable, certain foods completely mess me up as well!
> 
> Pasta and sometimes rice are awful for me and I have tried everything! Suggested I tried split doses - it doesn’t work! I’ve tried various different intervals of 30 mins, 1 hour, 1.5 hours, 2 hours etc and none of them seem to work and I end up either having a hypo or missing the boat and going too high!
> 
> I was then told to just do less insulin but this doesn’t work either as it doesn’t bring it down sufficiently so I have no idea what I’m supposed to do except not eat them…which majorly excludes me when I go for meals with people as we often go out to Indian and Italian restaurants!
> 
> Honestly at the moment I just feel like anything that could be an issue is an issue and that anything I try is not a solution, so frustrating!


Pasta and rice are annoying but also my favourite food! I think most T1s find an issue with pasta and rice - the insulin uses itself up on the glucose already in the blood and then there’s nothing left to stop the pasta glucose from doing whatever it likes


----------



## sg295

Lily123 said:


> Pasta and rice are annoying but also my favourite food! I think most T1s find an issue with pasta and rice - the insulin uses itself up on the glucose already in the blood and then there’s nothing left to stop the pasta glucose from doing whatever it likes


Yep same here, I love pasta especially but I can’t remember the last time I ate it because is causes too many problems.

Yeah I know they’re notorious for causing issues but what I find so frustrating is I have really tried all the strategies I can think of and none of them seem to work.

I also tried bolusing after the meal and that didn’t work either so literally run out of ideas now


----------



## sg295

rayray119 said:


> plus the whole going off to inject as a steward is a bit awkward(when I work though the evening) and I half to find a disert place as it might look odd to cowrds.


Yes I get you, if I can’t inject discreetly somewhere then I just don’t eat (which isn’t good as I’m only just a healthy weight as it is)


----------



## rayray119

porridge is an annoying breakfast as well.  pizza aslo annoying you can do extended boluses in pumps can't you?


----------



## rayray119

sg295 said:


> Yes I get you, if I can’t inject discreetly somewhere then I just don’t eat (which isn’t good as I’m only just a healthy weight as it is)


i don't mind doing out and about when I'm not working.  its just at work and i need to take my Levemir when I'm on shift sometimes


----------



## sg295

rayray119 said:


> porridge is an annoying breakfast as well.  pizza aslo annoying you can do extended boluses in pumps can't you?


Omg yes, I haven’t eaten porridge for months because it caused heaps of issues as well! Nearly forgot about that as I literally haven’t eaten it in forever! You can yes


----------



## nonethewiser

sg295 said:


> Yep same here, I love pasta especially but I can’t remember the last time I ate it because is causes too many problems.
> 
> Yeah I know they’re notorious for causing issues but what I find so frustrating is I have really tried all the strategies I can think of and none of them seem to work.
> 
> I also tried bolusing after the meal and that didn’t work either so literally run out of ideas now



See that's where pumps work wonders, ability to bolus upfront then rest of dose over as many hours as you want, lot easier than on pens.

Tbh dont avoid any foods nowadays, all are doable with right equipment knowledge & experience.


----------



## sg295

rayray119 said:


> i don't mind doing out and about when I'm not working.  its just at work and i need to take my Levemir when I'm on shift sometimes


Fair enough, I have massive issues with injecting in front of people which means I don’t really like going out socially anymore if it will involve injecting/eating and also means I’m losing weight as I’m not eating properly because of it as well


----------



## rayray119

nonethewiser said:


> See that's where pumps work wonders, ability bolus upfront then rest of disease over as many hours as you want, lot easier than on pens.
> 
> Tbh dont avoid any foods nowadays, all are doable with right equipment knowledge & experience.


how long have you been on a pump?


----------



## rayray119

sg295 said:


> Fair enough, I have massive issues with injecting in front of people which means I don’t really like going out socially anymore if it will involve injecting/eating and also means I’m losing weight as I’m not eating properly because of it as well


yeah i do get a bit awkward about it sometimes. paisley when I get looks like I'm taking drugs(and I'm thinking hey I'm just keeping myself alive) which is why I find it awkward at work.  i might even have to do in a truck on the 26th as I'll probably being eating on the way up and prbelly need to take my evening leivermir on why back when I'm travelling.


----------



## nonethewiser

rayray119 said:


> how long have you been on a pump?



10 years now, type 1 for 40.


----------



## Lily123

sg295 said:


> Yes I get you, if I can’t inject discreetly somewhere then I just don’t eat (which isn’t good as I’m only just a healthy weight as it is)


Is the reason you want to inject somewhere discreetly because you are worried about what other people will think? If so, you shouldn’t worry about what others will think. If they are strangers then it’s very unlikely that you will see them again or if they are friends then they won’t judge you. Or is it a completely different reason?


----------



## sg295

rayray119 said:


> yeah i do get a bit awkward about it sometimes. paisley when I get looks like I'm taking drugs(and I'm thinking hey I'm just keeping myself alive) which is why I find it awkward at work.  i might even have to do in a truck on the 26th as I'll probably being eating on the way up and prbelly need to take my evening leivermir on why back when I'm travelling.


Yeah it’s super difficult so I totally get where you’re coming from! All in all it’s a very tricky thing to deal with and when you have a super busy life on top it can seem impossible


----------



## rayray119

nonethewiser said:


> 10 years now, type 1 for 40.


ah so years after being diagnosed then.


----------



## sg295

Lily123 said:


> Is the reason you want to inject somewhere discreetly because you are worried about what other people will think? If so, you shouldn’t worry about what others will think. If they are strangers then it’s very unlikely that you will see them again or if they are friends then they won’t judge you. Or is it a completely different reason?


Honestly I’m not sure, I can’t work it out. I hate injecting in front of strangers but even people I’m more familiar with it’s a struggle, just less of one.

The time I feel most comfortable is when I’m completely on my own


----------



## Lily123

sg295 said:


> Honestly I’m not sure, I can’t work it out. I hate injecting in front of strangers but even people I’m more familiar with it’s a struggle, just less of one


Maybe you could try and break down that fear? Like try and think a psychological reason for the fear? I can’t be of much help as I don’t really care what others think if they are being negative on purpose. Constructive criticism is okay though


----------



## sg295

Lily123 said:


> Maybe you could try and break down that fear? Like try and think a psychological reason for the fear? I can’t be of much help as I don’t really care what others think if they are being negative on purpose. Constructive criticism is okay though


Yeah I’ve tried many things to get over it but nothing I do seems to help really so it’s another thing for me to discuss next week as it’s getting in the way of a lot of things


----------



## nonethewiser

rayray119 said:


> ah so years after being diagnosed then.


 
Nobody goes straight to pump, or didnt use to. Was offered pump earlier than 10 years but declined, with hindsight should have grabbed opportunity.


----------



## rayray119

sg295 said:


> Yeah it’s super difficult so I totally get where you’re coming from! All in all it’s a very tricky thing to deal with and when you have a super busy life on top it can seem impossible





sg295 said:


> Honestly I’m not sure, I can’t work it out. I hate injecting in front of strangers but even people I’m more familiar with it’s a struggle, just less of one.
> 
> The time I feel most comfortable is when I’m completely on my own


i aslo do stuggle with what people think so I understand/


----------



## Lily123

sg295 said:


> Yeah I’ve tried many things to get over it but nothing I do seems to help really so it’s another thing for me to discuss next week as it’s getting in the way of a lot of things


Hopefully your DSN will be able to help you figure out why you don’t want to inject infront of others


----------



## rayray119

nonethewiser said:


> Nobody goes straight to pump, or didnt use to. Was offered pump earlier than 10 years but declined, with hindsight should have grabbed opportunity.


that's exactly why i'm afraid to ask just 5 and a half months 6 months on the 4th of march


----------



## Lily123

rayray119 said:


> i aslo do stuggle with what people think so I understand/


Do you think your fear is because of what other people might think?


----------



## sg295

Lily123 said:


> Hopefully your DSN will be able to help you figure out why you don’t want to inject infront of others


Yeah I hope so, I’m not sure if they’ll have any ideas on how to get over it.

I’ve tried a few things like injecting in front of family/close friends to build up confidence but doesn’t seem to be making much difference, injecting through clothes but still no improvement so not really sure what else to do


----------



## Lily123

sg295 said:


> Yeah I hope so, I’m not sure if they’ll have any ideas on how to get over it.
> 
> I’ve tried a few things like injecting in front of family/close friends to build up confidence but doesn’t seem to be making much difference, injecting through clothes but still no improvement so not really sure what else to do


Have you spoken to your family and friends about this fear? They may be able to reassure you that they have no issues with you injecting in front of them


----------



## nonethewiser

rayray119 said:


> that's exactly why i'm afraid to ask just 5 and a half months 6 months on the 4th of march



Well sure 6 months was minimum time so you could ask, nothing ventured nothing gained.


----------



## rayray119

well i going to ring the time in morning because I cant take he's random highs anymore.


----------



## rayray119

Lily123 said:


> Do you think your fear is because of what other people might think?


yeah epically at work, i worry if they spectres sees steward injecting something there their think the worst. my crazy highs have had start when I work are allowing me to travel again.  their comments is "you're on medication now so we're hoping it stablished" yeah if only it worked like that.


----------



## Lily123

rayray119 said:


> yeah epically at work, i worry if they spectres sees steward injecting something there their think the worst. my crazzy highs have had start when I work are allowing me to travel again.  their comments is "you're on medication now so we're hoping it established" yeah if only it worked like that.


They are just ignorant. Like @Benny G says no one will notice and even if they do then it’s there own problem if they do assume the worst


----------



## Pumper_Sue

Lily123 said:


> Good news! I had my appointment today and the diabetes team said that I should come to the pump and technology day in April! So it wasn’t a no


That's fantastic  so pleased for you.


----------



## Lily123

Pumper_Sue said:


> That's fantastic  so pleased for you.


Thanks! I only know when it is and don’t know if it’s virtual or in person because of Covid


----------



## rayray119

Lily123 said:


> They are just ignorant. Like @Benny G says no one will notice and even if they do then it’s there own problem if they do assume the worst


yes i do need to get work to understand how diabeetes because one of the reasons they give me before was "your blood sugers"


----------



## Lily123

rayray119 said:


> yes i do need to get work to understand how diabeetes because one of the reasons they give me before was "your blood sugers"


What were they finding an excuse for? Do they know you need to be able to stop what you are doing when hypo and things like that?


----------



## rayray119

ive jhttps://jdrf.org.uk/information-support/treatments-technologies/insulin-pump-therapy/can-i-get-an-insulin-pump-on-the-nhs/?fbclid=IwAR0N4BZD7EcuLfVTx4b9xBPzTPIzIYH7hkIBDYwRyteob1RREapp1oK9Cyoust found this


----------



## rayray119

Lily123 said:


> What were they finding an excuse for? Do they know you need to be able to stop what you are doing when hypo and things like that?


they just seem to think if its numbers not normal its a reason to panic


----------



## Lily123

rayray119 said:


> ive jhttps://jdrf.org.uk/information-support/treatments-technologies/insulin-pump-therapy/can-i-get-an-insulin-pump-on-the-nhs/?fbclid=IwAR0N4BZD7EcuLfVTx4b9xBPzTPIzIYH7hkIBDYwRyteob1RREapp1oK9Cyoust found this


The issue is that the NICE guidelines specify HbA1C of 69 which yours may be a lot lower than that at your next appointment- there’s no harm in asking. When I asked about a pump , I explained that I felt like I was being punished for managing well because of what the guidelines stated. The Dr agreed with me!


----------



## Lily123

rayray119 said:


> they just seem to think if its numbers not normal its a reason to panic


Sometimes it can be a reason to panic but you should speak to them to get them to understand when they would need to worry rather than worrying at one not in range number that they are told about


----------



## rayray119

Lily123 said:


> The issue is that the NICE guidelines specify HbA1C of 69 which yours may be a lot lower than that at your next appointment- there’s no harm in asking. When I asked about a pump , I explained that I felt like I was being punished for managing well because of what the guidelines stated. The Dr agreed with me!


sorry it isnt nice gudelines its saying how you might be able to make case if you don't fit my issues at the moment are diffiatty affecting the qauity of life.


----------



## Lily123

rayray119 said:


> sorry it isnt nice gudelines its saying how you might be able to make case if you don't fit my issues at the moment are diffiatty affecting the qauity of life.


Ah, under the guidance from ABCD. You do shift work don’t you? That would be a point for getting a pump because of the ability of temporary basal and things like that.


----------



## rayray119

Lily123 said:


> Sometimes it can be a reason to panic but you should speak to them to get them to understand when they would need to worry rather than worrying at one not in range number that they are told about


yes they did say if something was to happen on shift I wouldn't be able to travel as they looking ut for my well being I'm hoping by that they mean something serious happening and not just I need to eat jelly babies or inject insullin.


----------



## rayray119

Lily123 said:


> Ah, under the guidance from ABCD. You do shift work don’t you? That would be a point for getting a pump because of the ability of temporary basal and things like that.


yes i do shift work. which is abig reason as well as the other problems


----------



## Lily123

rayray119 said:


> yes i do shift work. which is abig reason as well as the other problems


Maybe write all the reasons down in a list so you have every reason that a pump could help with ready for your appointment?


----------



## Lily123

rayray119 said:


> yes they did say if something was to happen on shift I wouldn't be able to travel as they looking ut for my well being I'm hoping by that they mean something serious happening and not just I need to eat jelly babies or inject insullin.


It’s better that they care rather than not caring even if they seem to be going a bit overboard


----------



## rayray119

Lily123 said:


> It’s better that they care rather than not caring even if they seem to be going a bit overboard


yes i know it is a good they care. i think they might have meant if I claspled or anything or get rushed to hostpal(which hpfully wont happen again)


----------



## Lily123

rayray119 said:


> yes i know it is a good they care. i think they might have meant if I claspled or anything or get rushed to hostpal(which hpfully wont happen again)


They most likely did mean worst case scenario


----------



## trophywench

Well for whatever reason it happened, I couldn't give a monkeys what random other people think of me!  As long as the people who actually AFFECT my life are OK with me and my behaviour - all's fine.


----------



## rayray119

Lily123 said:


> They most likely did mean worst case scenario


howver im bit worred about saterday since I cant seem to get below10 until somepont in the evening or atenoon before dinner and in the then shoot up again at sompoint in the evening which is making me feel ptrrty awful physiccy


----------



## Lily123

trophywench said:


> Well for whatever reason it happened, I couldn't give a monkeys what random other people think of me!  As long as the people who actually AFFECT my life are OK with me and my behaviour - all's fine.


Exactly my way of thinking!


----------



## Lily123

rayray119 said:


> howver im bit worred about saterday since I cant seem to get below10 until somepont in the evening or atenoon before dinner and in the then shoot up again at sompoint in the evening which is making me feel ptrrty awful physiccy


I think that means you need to adjust your insulin to carb ratios or basal insulin if this is happening quite often


----------



## rayray119

Lily123 said:


> I think that means you need to adjust your insulin to carb ratios or basal insulin if this is happening quite often


yeah i can think of somthing that it might be this week now I'll just ceribated 8.9


----------



## Lily123

rayray119 said:


> yeah i can think of somthing that it might be this week now I'll just ceribated 8.9


Is it only happening when you’re at work?


----------



## helli

rayray119 said:


> howver im bit worred about saterday since I cant seem to get below10 until somepont in the evening or atenoon before dinner and in the then shoot up again at sompoint in the evening which is making me feel ptrrty awful physiccy


This sounds like the kind of thing you will get assistance and more knowledge how to manage during the DAFNE course.
I encourage you to push for DAFNE. As mentioned previousl, it is usually a prerequisite for a pump so you will not be wasting your time and getting the next step up the pump ladder.
(Sorry, my weird mind is now trying to picture a pump ladder - is it a ladder made up of pumps or a ladder over a pile of pumps?)


----------



## sg295

rayray119 said:


> yeah i can think of somthing that it might be this week now I'll just ceribated 8.9


I get you, I’ve had a couple of instances where I think I’m having hypos when I’m in the low 5s the last few days as I’ve been higher than normal recently…really not nice as it means I’m feeling pretty bad for no reason


----------



## Lily123

helli said:


> (Sorry, my weird mind is now trying to picture a pump ladder - is it a ladder made up of pumps or a ladder over a pile of pumps?)


My mind is saying a ladder made of pumps


----------



## Lily123

sg295 said:


> I get you, I’ve had a couple of instances where I think I’m having hypos when I’m in the low 5s the last few days as I’ve been higher than normal recently…really not nice as it means I’m feeling pretty bad for no reason


Sometimes if your BG drops quickly it can make you feel hypo


----------



## sg295

Lily123 said:


> Sometimes if your BG drops quickly it can make you feel hypo


Yeah may have been that but I also have been running higher as a general rule, have been cruising in 7s and 8s a lot of the time with lower levels only really in the morning before I eat


----------



## Lily123

sg295 said:


> Yeah may have been that but I also have been running higher as a general rule, have been cruising in 7s and 8s a lot of the time with lower levels only really in the morning before I eat


That could be why. If you’ve been running a bit higher then your body won’t be used to more in range levels


----------



## sg295

Lily123 said:


> That could be why. If you’ve been running a bit higher then your body won’t be used to more in range levels


Yes that’s what I thought, I think my basal needs some adjusting but I still need to get a half unit pen and also I have reduced my insulin to carb ratio but it’s a very awkward number and if I round it it’s either too much or not enough


----------



## Lily123

sg295 said:


> Yes that’s what I thought, I think my basal needs some adjusting but I still need to get a half unit pen and also I have reduced my insulin to carb ratio but it’s a very awkward number and if I round it it’s either too much or not enough


What basal insulin do you use?


----------



## rayray119

Lily123 said:


> Is it only happening when you’re at work?


no not been at work this week(supose to work Saturday) but just relissed I've come down with something and there's something else on top of that.


----------



## rayray119

sg295 said:


> Yeah may have been that but I also have been running higher as a general rule, have been cruising in 7s and 8s a lot of the time with lower levels only really in the morning before I eat


its not interntally runing high i;ve been struggling to stay bellow 10 this week.


----------



## Lily123

rayray119 said:


> no not been at work this week(supose to work Saturday) but just relissed I've come down with something and there's something else on top of that.


Ah, if you’ve got a cold or anything like that it will raise your BG


----------



## sg295

Lily123 said:


> What basal insulin do you use?


Lantus


----------



## Lily123

sg295 said:


> Lantus


I used to use Lantus and the half unit pen for it was the Sanofi JuniorStar. I’m not sure if there is another half unit pen that works with Lantus cartridges.


----------



## sg295

Lily123 said:


> I used to use Lantus and the half unit pen for it was the Sanofi JuniorStar. I’m not sure if there is another half unit pen that works with Lantus cartridges.


Ah ok thanks, yeah I’ve heard of the junior star. I actually don’t have the cartridges currently as mine is a pre-filled pen so does the junior star have separate cartridges?


----------



## Lily123

sg295 said:


> Ah ok thanks, yeah I’ve heard of the junior star. I actually don’t have the cartridges currently as mine is a pre-filled pen so does the junior star have separate cartridges?


Yes the JuniorStar is a reusable pen but I think there may be a non-reusable Lantus pen, I just remembered. The JuniorStar does take cartridges


----------



## sg295

Lily123 said:


> Yes the JuniorStar is a reusable pen but I think there may be a non-reusable Lantus pen, I just remembered. The JuniorStar does take cartridges


Ok cool thank you


----------



## rayray119

Lily123 said:


> Ah, if you’ve got a cold or anything like that it will raise your BG


yeah i hate being ill with it. i thought it was going high which was making me feel grim but it turns out I think I'm ill anyway


----------



## Lily123

rayray119 said:


> yeah i hate being ill with it. i thought it was going high which was making me feel grim but it turns out I think I'm ill anyway


Most illnesses like colds or sick bugs will (most likely) send BG very high


----------



## helli

rayray119 said:


> yeah i hate being ill with it. i thought it was going high which was making me feel grim but it turns out I think I'm ill anyway


Being ill can turn into a vicious cycle.
Stress on the body, such as a cold, can cause your liver to dump glucose and raise levels. Raised levels exaggerate any aches, pains, sniffs, coughs, … which lead to more liver dumps which raise levels higher which …
The trick is to treat highs when unwell and keep levels lower.


----------



## rayray119

helli said:


> Being ill can turn into a vicious cycle.
> Stress on the body, such as a cold, can cause your liver to dump glucose and raise levels. Raised levels exaggerate any aches, pains, sniffs, coughs, … which lead to more liver dumps which raise levels higher which …
> The trick is to treat highs when unwell and keep levels lower.


ive been told not to correct withen 4 hours after having insullin.


----------



## rayray119

the nurse i spoke to dosent seem to be bothered because as long asim not getting keytones its fine apartellty


----------



## Lily123

rayray119 said:


> ive been told not to correct withen 4 hours after having insullin.


Does your BG meter work out the amount of bolus insulin you need or do you use an app like mySugr?


----------



## rayray119

Lily123 said:


> Does your BG meter work out the amount of bolus insulin you need or do you use an app like mySugr?


i do use my suger for longing stuff but they seem very amdement not to give myself anymore insulin until the 4 hours are up.


----------



## Lily123

rayray119 said:


> i do use my suger for longing stuff but they seem very amdement not to give myself anymore insulin until the 4 hours are up.


The app should calculate a corrective dose if needed and just take away how much insulin would still be active from the last injection


----------



## rayray119

rayray119 said:


> i do use my suger for longing stuff but they seem very amdement not to give myself anymore insulin until the 4 hours are up.they didnt even see


i tend callucte doses myslef for some reason my team don't want me to  give any insulin to bring stuff down until the   hours are up, whatever


----------



## rayray119

at first she just kept doing what you're doing because it's better to be high than low which I understand but not going up 15 and 16 and not saying below 10, the highest and stop staying bellow 10


----------



## Lily123

rayray119 said:


> at first she just kept doing what you're doing because it's better to be high than low which I understand but not going up 15 and 16 and not saying below 10, the highest and stop staying bellow 10


It’s not better to be either high or low as both can be dangerous


----------



## rayray119

but i mean if i'm 15 3 hours after eating changes are I'm not going to come back down in an hour


----------



## Lily123

rayray119 said:


> but i mean if i'm 15 3 hours after eating changes are I'm not going to come back down in an hour


It depends on how much insulin you originally had and what your number was before eating but you should be able to correct that


----------



## rayray119

Lily123 said:


> It’s not better to be either high or low as both can be dangerous


yes i know this is exactly why I'm getting concerned at my teams advise they never seem to be overly concerned unless your having loads of hypos i old seeing 16s and 17s and she was like only worry if its really high like 27


----------



## Lily123

rayray119 said:


> yes i know this is exactly why I'm getting concerned at my teams advise they never seem to be overly concerned unless your having loads of hypos i old seeing 16s and 17s and she was like only worry if its really high like 27


I think you need to speak to your diabetes team. Explain your worries about your BG and they should be able to help you find a solution or at least reassure you


----------



## rayray119

i difantty th


Lily123 said:


> I think you need to speak to your diabetes team. Explain your worries about your BG and they should be able to help you find a solution or at least reassure you


this was a phone call with someone from my team


----------



## rayray119

i think my livermir is wearing off around 7


----------



## Lily123

rayray119 said:


> i think my livermir is wearing off around 7


What time do you take your Levemir in the morning?


----------



## rayray119

Benny G said:


> You have to show that you understand the basics before moving on to advanced theory


----------



## rayray119

Lily123 said:


> What time do you take your Levemir in the morning?


8 and 9 in the evening but i think it starts wearing.but she said just take when you get and when you go to bed but I know that's never going to work because its difinatty times I think I need something that lasts longer but more flexible then trisbria


----------



## rayray119

rayray119 said:


> 8 and 9 in the evening but i think it starts wearing.but she said just take when you get and when you go to bed but I know that's never going to work because its difinatty times I think I need something that lasts longer but more flexible then trisbria


which obivoulsy pumps last all though the day


----------



## rayray119

Lily123 said:


> It depends on how much insulin you originally had and what your number was before eating but you should be able to correct that


2.5 units


----------



## Lily123

rayray119 said:


> 8 and 9 in the evening but i think it starts wearing.but she said just take when you get and when you go to bed but I know that's never going to work because its difinatty times I think I need something that lasts longer but more flexible then trisbria


Have you tried Lantus?


----------



## Lily123

rayray119 said:


> 2.5 units


How many hours after was that number? If the insulin is NovoRapid then it has a profile of about 4 hours


----------



## rayray119

yes i may have correcected half a hour early but t


----------



## Lily123

rayray119 said:


> yes i may have correcected half a hour early but t


I do corrections less than 4 hours apart if I need to because the BG meter I use takes into account the insulin that will still be active from the last injection


----------



## trophywench

helli said:


> This sounds like the kind of thing you will get assistance and more knowledge how to manage during the DAFNE course.
> I encourage you to push for DAFNE. As mentioned previousl, it is usually a prerequisite for a pump so you will not be wasting your time and getting the next step up the pump ladder.
> (Sorry, my weird mind is now trying to picture a pump ladder - is it a ladder made up of pumps or a ladder over a pile of pumps?)


Unfortunately the rungs appear to be made out of pump tubing and hence may be very difficult to negotiate sometimes .....


----------



## helli

rayray119 said:


> i think my livermir is wearing off around 7


What makes you think your Levemir is wearing off and it is not Dawn Phenomenon?


----------



## rayray119

helli said:


> What makes you think your Levemir is wearing off and it is not Dawn Phenomenon?


i was refering to 7 in the evening sorry but it might not be that.


----------



## rayray119

anyway sorry i probelly derailed this thread enough


----------



## Lily123

rayray119 said:


> anyway sorry i probelly derailed this thread enough


No need to apologise


----------



## rayray119

wondering how i should pharse the qustion if i do mange to pick up the coverage for tommorow.


----------



## Lily123

rayray119 said:


> wondering how i should pharse the qustion if i do mange to pick up the coverage for tommorow.


Maybe you could say it like: I’m wondering if an insulin pump would help me manage my numbers better?


----------



## rayray119

Lily123 said:


> Maybe you could say it like: I’m wondering if an insulin pump would help me manage my numbers better?


yeah one big reason is my job and not being able to predict exacllty how active it is. and the fact I'm suspecting I have different back round needs for different times of days which is just impossible of pens.


----------



## Proud to be erratic

Lily123 said:


> I do corrections less than 4 hours apart if I need to because the BG meter I use takes into account the insulin that will still be active from the last injection


@Lily123 may I ask what meter do you use and what is the process for "informing" the device about the types of insulin you are using?
Also, do you 'ask' the meter what correction you can take  or do you suggest what you think the correction needs to be and it corrects your suggestion if you have too much insulin already on board? 
Have you previously defined what your optimum target is? Presumably the meter has a generic formula for the life of each type of insulin and if that is so does the meter handbook (or online) tell you what assumptions it has made for your insulins? Or are you able to inform it about how your body is responding to that particular insulin (or does it have the equivalent of simple artificial intelligence)?

I'm curious about how this all works. I'm MDI and calc my boluses, calc my corrections and apply my own factor for reduction when I'm 'active'. I don't do formal exercise, ie go to a gym or similar, but I try to spend a decent amount of time doing 'jobs' or walking, which I call moderate activity; sometimes high activity if digging in the garden for a while.


----------



## Lily123

Proud to be erratic said:


> @Lily123 may I ask what meter do you use and what is the process for "informing" the device about the types of insulin you are using?
> Also, do you 'ask' the meter what correction you can take  or do you suggest what you think the correction needs to be and it corrects your suggestion if you have too much insulin already on board?
> Have you previously defined what your optimum target is? Presumably the meter has a generic formula for the life of each type of insulin and if that is so does the meter handbook (or online) tell you what assumptions it has made for your insulins? Or are you able to inform it about how your body is responding to that particular insulin (or does it have the equivalent of simple artificial intelligence)?
> 
> I'm curious about how this all works. I'm MDI and calc my boluses, calc my corrections and apply my own factor for reduction when I'm 'active'. I don't do formal exercise, ie go to a gym or similar, but I try to spend a decent amount of time doing 'jobs' or walking, which I call moderate activity; sometimes high activity if digging in the garden for a while.


The meter I use is an Accu-Chek Aviva Expert - they no longer make them.The meter knows what my carb to insulin ratios are for each time block and also knows my correction factor and it also knows my target range (I can’t remember what it is  ) and aims for the middle of that range.The meter also knows the insulin duration so it can calculate from that how much insulin is still on board - The “active insulin” in only the correction as any insulin it works out for carbs it assumes it will be used up for carbs


----------



## rayray119

sg295 said:


> Yep same here, I love pasta especially but I can’t remember the last time I ate it because is causes too many problems.
> 
> Yeah I know they’re notorious for causing issues but what I find so frustrating is I have really tried all the strategies I can think of and none of them seem to work.
> 
> I also tried bolusing after the meal and that didn’t work either so literally run out of ideas now


saying this i was put of pizza on when first dinoasged because I had of all the problems but I was encouraged my team to try it. my last pizza didn't work out too bad but I didn't have a sensor one so didn't see how bad it actually got )


----------



## rayray119

Lily123 said:


> The meter I use is an Accu-Chek Aviva Expert - they no longer make them.The meter knows what my carb to insulin ratios are for each time block and also knows my correction factor and it also knows my target range (I can’t remember what it is  ) and aims for the middle of that range.The meter also knows the insulin duration so it can calculate from that how much insulin is still on board - The “active insulin” in only the correction as any insulin it works out for carbs it assumes it will be used up for carbs


sounds like you allready have a bit of practice for what a pump will work out then.


----------



## sg295

rayray119 said:


> saying this i was put of pizza on when first dinoasged because I had of all the problems but I was encouraged my team to try it. my last pizza didn't work out too bad but I didn't have a sensor one so didn't see how bad it actually got )


Interestingly, pizza isn’t too bad for me (touch wood!)

But pasta is absolutely impossible and rice is very hit and miss - sometimes it’s ok (ish) and other times fails miserably and I’m never quite sure which way it’s going to go!

Therefore I just don’t really eat them anymore, which is a shame as I used to LOVE pasta especially


----------



## rayray119

most people gernally have a weeks partice with saline in right?


----------



## rayray119

the only thing i'm waering of if they fail as much as my libre sensors that's going become a problem


----------



## sg295

rayray119 said:


> the only thing i'm waering of if they fail as much as my libre sensors that's going become a problem


I’ve heard it’s quite rare for a pump to fail (can happen but shouldn’t happen as much as that)


----------



## Lily123

rayray119 said:


> the only thing i'm waering of if they fail as much as my libre sensors that's going become a problem


It would more likely be a blocked or kinked cannula rather than the actual pump


----------



## Lily123

rayray119 said:


> sounds like you allready have a bit of practice for what a pump will work out then.


I do a finger prick like with any other meter and then tell it how many carbs I’m about to eat and it works it out for me


----------



## rayray119

Lily123 said:


> It would more likely be a blocked or kinked cannula rather than the actual pump


i wonder how easy it is to apply the omipod.


----------



## Lily123

rayray119 said:


> i wonder how easy it is to apply the omipod.


I’m not sure


----------



## trophywench

rayray119 said:


> most people gernally have a weeks partice with saline in right?


I certainly didn't!  

Had to learn to use it 'on the hoof', with the manual open!


----------



## trophywench

@rayray - you shouldn't be suspecting such things.  You should be able to show the clinic the proof of it from your BG testing or Librelink results at various times of day.


----------



## rayray119

trophywench said:


> @rayray - you shouldn't be suspecting such things.  You should be able to show the clinic the proof of it from your BG testing or Librelink results at various times of day.


that's why I need to get some background tests done to confirm it,  I'm not using the libre at the moment.  i only said I was suspecting it.


----------



## Inka

rayray119 said:


> most people gernally have a weeks partice with saline in right?



No, I didn’t. Got it programmed, had a talk through, loaded the insulin,  put the cannula in and off I went.


----------



## helli

rayray119 said:


> i wonder how easy it is to apply the omipod.


There are plenty of YouTube videos to show you.
But judging by the number of people with the Omnipod, I doubt if it that difficult.
However, I would discourage you from researching any specific pumps until you have spoken to your clinic and found out what they offer. OmniPod is not an option for me, for example.


----------



## helli

rayray119 said:


> most people gernally have a weeks partice with saline in right?


I had a week to practice filling my pump with saline, applying it and familusing myself with the controls but did I not have to have it attached for the full week which was good because I quickly found the cannulas did not suit me.


----------



## rayray119

helli said:


> There are plenty of YouTube videos to show you.
> But judging by the number of people with the Omnipod, I doubt if it that difficult.
> However, I would discourage you from researching any specific pumps until you have spoken to your clinic and found out what they offer. OmniPod is not an option for me, for example.


I allready know omipod is an option because other people in my area with them I’m on Facebook group for type 1s in my area and I met someone also one of best friends is type 1 and she’s on the omnipod as well as others in my area


----------



## nonethewiser

rayray119 said:


> i wonder how easy it is to apply the omipod.



Really easy mate, whole procedure filling activation priming applying takes about 5mins, quicker with practice.


----------



## Lily123

Lily123 said:


> The meter I use is an Accu-Chek Aviva Expert - they no longer make them.The meter knows what my carb to insulin ratios are for each time block and also knows my correction factor and it also knows my target range (I can’t remember what it is  ) and aims for the middle of that range.The meter also knows the insulin duration so it can calculate from that how much insulin is still on board - The “active insulin” in only the correction as any insulin it works out for carbs it assumes it will be used up for carbs


Oh and forget to add - the meter doesn’t know what the insulin is but knows the duration


----------



## trophywench

Lily123 said:


> Oh and forget to add - the meter doesn’t know what the insulin is but knows the duration


Yes cos you  have to tell it to begin with so for Novorapid, that's 4 & a half hours.  Haven't a clue what they put in for other insulins as I've not had to change so far.


----------



## Lily123

trophywench said:


> Yes cos you  have to tell it to begin with so for Novorapid, that's 4 & a half hours.  Haven't a clue what they put in for other insulins as I've not had to change so far.


Is the handset for the Combo the same,but just with a few pump extras?


----------



## trophywench

Yeah - an Expert with knobs on!


----------



## rayray119

nonethewiser said:


> Really easy mate, whole procedure filling activation priming applying takes about 5mins, quicker with practice.


i'm also dypraxix so i'm thing of that too


----------



## Proud to be erratic

Lily123 said:


> Oh and forget to add - the meter doesn’t know what the insulin is but knows the duration


Thank you @Lily123 for both posts.


----------



## rayray119

Lily123 said:


> I do a finger prick like with any other meter and then tell it how many carbs I’m about to eat and it works it out for me


sorry i just saw this reply I meant pumps also work out carbs for you.  can I ask though that you're team aren't fussy about you doing figer pricks still while st on the libre. my team seem convinced when on the libre you barely need to do any at all. however I felt that I least did at meal times and sometimes at other times as well. because of some things I would sometimes see


----------



## rayray119

trophywench said:


> Yes cos you  have to tell it to begin with so for Novorapid, that's 4 & a half hours.  Haven't a clue what they put in for other insulins as I've not had to change so far.


i was told novorapid lasts 4 hours?


----------



## helli

rayray119 said:


> i was told novorapid lasts 4 hours?


As has often been said, we are all different and we need to find out what works best for us. 
The official advice is that NovoRapid lasts 4 hours. Obviously,  @trophywench finds it affects her for a bit longer, I found it affected me for less. 
Four hours is a good approximation for most people. especially if you are not using it in an insulin pump.


----------



## Pumper_Sue

helli said:


> The official advice is that NovoRapid lasts 4 hours.


Where does that official advice come from? Even Fiasp lasts 5 hours.


----------



## helli

Pumper_Sue said:


> Where does that official advice come from? Even Fiasp lasts 5 hours.


Perhaps "official" was the wrong word. 
I meant "usual advice from HCPs". Although the insulin remains active for longer than 4 hours, most of us (but not all) find that the remaining active insulin is so small that it has little affect to consider when "stack dosing".


----------



## rayray119

helli said:


> As has often been said, we are all different and we need to find out what works best for us.
> The official advice is that NovoRapid lasts 4 hours. Obviously,  @trophywench finds it affects her for a bit longer, I found it affected me for less.
> Four hours is a good approximation for most people. especially if you are not using it in an insulin pump.


there was a time at the biging where I was supausting it lasts longer for me also also it depends sometimes it seems to get into my system pretty quickly aftertimes it doesn't


----------



## rayray119

trying to work up the corrage to at least mention pumps today though. although my minds convinces me they'll shut it down but i want know until i ask. i know you said danffe is offered a prerequisite however i am being referred to it.  my plan is to explain how unpredictable my job is and other stuff.  i haven't met her yet and don't know if i will one of the consuldents at my hospital is actually type 1 diabetic herself so if I haven't to have the appointment with her that might even help.


----------



## rayray119

well the awser that i got was "we're not saying no but not yet"  the way he outlined it was danffe first(really hope that letter with the date comes soon) then back on the libre or another tech(he wanted to consider going back on(but I explained about all the challenges I had with it and how that ended making more unhelpful than helpful) or some other sensor if available(he said they'll keep on open mind on that option and see what they say in march)  then poteniitoy a pump downline.  he said that I'll be seeing a different consultant from now on though)   so I didn't get a downright no. it's maybe some time in the feature not really an idea of how long in feature though.


----------



## rayray119

so i got work to do to turn that maybe in future to perpharps shorten the time frame.


----------



## Lily123

rayray119 said:


> sorry i just saw this reply I meant pumps also work out carbs for you.  can I ask though that you're team aren't fussy about you doing figer pricks still while st on the libre. my team seem convinced when on the libre you barely need to do any at all. however I felt that I least did at meal times and sometimes at other times as well. because of some things I would sometimes see


I’m still in paediatrics as I’m 14 but because you’re not on the Libre then they can’t tell you how many finger pricks to do - within reason.


----------



## Lily123

rayray119 said:


> well the awser that i got was "we're not saying no but not yet"  the way he outlined it was danffe first(really hope that letter with the date comes soon) then back on the libre or another tech(he wanted to consider going back on(but I explained about all the challenges I had with it and how that ended making more unhelpful than helpful) or some other sensor if available(he said they'll keep on open mind on that option and see what they say in march)  then poteniitoy a pump downline.  he said that I'll be seeing a different consultant from now on though)   so I didn't get a downright no. it's maybe some time in the feature not really an idea of how long in feature though.


You didn’t get a no then so that’s good. Maybe the new consultant with be more open minded


----------



## rayray119

Lily123 said:


> I’m still in paediatrics as I’m 14 but because you’re not on the Libre then they can’t tell you how many finger pricks to do - within reason.


yes i was refering to when was on the libre.  but some nurses still try to even now I'm not you think because of my episode the other week they would want me to testing more.      the funny thing is if I was a child I would qualify for sensors because of my other things that cause similar symptoms but because I'm not a child I'm not.


----------



## Lily123

rayray119 said:


> yes i was refering to when was on the libre.  but some nurses still try to even now I'm not you think because of my episode the other week they would want me to testing more.      the funny thing is if I was a child I would qualify for sensors because of my other things that cause similar symptoms but because I'm not a child I'm not.


I honestly don’t know how I qualified for Libre - I don’t think I met the guidelines but still it’s helpful to me. I still do finger pricks at every meal and whenever I want to eat as for the bolus calculator on my BG meter you need a finger prick and doesn’t let you input Libre readings


----------



## rayray119

Lily123 said:


> You didn’t get a no then so that’s good. Maybe the new consultant with be more open minded


i;m suspecting it might be the one I heard about from other people that is also diabetic,     when he uploaded my meter it was saying 60% over the last month(obislly i want now without sort of sensor what exactly it was ) what was in target.  which i was a bit disappointed with but he was saying considering I've been ill last week (which i think actually started to affect my blood sugars the week before that wasn't bad).


----------



## Lily123

rayray119 said:


> i;m suspecting it might be the one I heard about from other people that is also diabetic,     when he uploaded my meter it was saying 60% over the last month(obislly i want now without sort of sensor what exactly it was ) what was in target.  which i was a bit disappointed with but he was saying considering I've been ill last week (which i think actually started to affect my blood sugars the week before that wasn't bad).


60% time in target is good


----------



## rayray119

Lily123 said:


> I honestly don’t know how I qualified for Libre - I don’t think I met the guidelines but still it’s helpful to me. I still do finger pricks at every meal and whenever I want to eat as for the bolus calculator on my BG meter you need a finger prick and doesn’t let you input Libre readings


ah well, at least i'm not the onllt one which felt i sometimes needed to back it up. I'm going to see what guidelines in march because the libre just didn't seem to sort me. I'm hoping its as positive as what parthas making out. I heard earlier in the year before dianosged


----------



## rayray119

perhaps when i do see the another consent i should pose the question again


----------



## Lily123

rayray119 said:


> ah well, at least i'm not the onllt one which felt i sometimes needed to back it up. I'm going to see what guidelines in march because the libre just didn't seem to sort me. I'm hoping its as positive as what parthas making out. I heard earlier in the year before dianosged


Hopefully they may offer you a different sensor as Libre didn’t work well for you


----------



## rayray119

Lily123 said:


> Hopefully they may offer you a different sensor as Libre didn’t work well for you


sorry I sent it before finishing my post i heard earlier in the year Dexcom were ordering offering free trails but aren't anymore if they were I still I would considering getting it just to see if it worked better for me and then I could use that(but they don't anymore so that's not an option), parha seems to be suggesting their will be a choice but maybe I miss interesting that. 


Lily123 said:


> You didn’t get a no then so that’s good. Maybe the new consultant with be more open minded


although it was still kind of a no, maybe once I do danffee things will become clearer whether I'll be allowed that,


----------



## rayray119

he was impressed with my last hb1ac my the nurse I asked for the result of was concerned. i guess my next one will be due in April if my I had it done in janurry?


----------



## Lily123

rayray119 said:


> he was impressed with my last hb1ac my the nurse I asked for the result of was concerned. i guess my next one will be due in April if my I had it done in janurry?


I’m not sure when you’re next one would be , if your appointments are every 3 months then I’d assume so


----------



## rayray119

Lily123 said:


> I’m not sure when you’re next one would be , if your appointments are every 3 months then I’d assume so


i though they were suposed to measured every 3 months


----------



## Lily123

rayray119 said:


> i though they were suposed to measured every 3 months


I think so , but I’m not sure how it’s run in adult clinics


----------



## helli

rayray119 said:


> i though they were suposed to measured every 3 months


As HbA1c is an average over the last 3 months, there is no point taking it any sooner. However, it is rare to have the test that often. Mine is measured every 12 months. 
There is no "supposed to be measured" period apart from at least once per year.  It depends upon the clinic and the patient.


----------



## rayray119

helli said:


> As HbA1c is an average over the last 3 months, there is no point taking it any sooner. However, it is rare to have the test that often. Mine is measured every 12 months.
> There is no "supposed to be measured" period apart from at least once per year.  It depends upon the clinic and the patient.


I'll ask in Facebook. group.


----------



## rayray119

i ateclly didn't quite manged o gt the question out but he knew what I was going to ask by the way of wording things.


----------



## Lily123

I went to the pump & and technology info day today and have narrowed down my choice to: Omnipod dash, Dana I or T:slim. Any thoughts?

And because I don’t meet the guidelines the diabetes team are most likely going to put in a individual funding request


----------



## helli

Glad you are getting see the pumps and learn more about them.
I don't have any experience of any of your short list but at least the OmniPod and T-slim are popular so you should get some feedback. There is talk of a new OminPod 5 coming out soon. You may automatically get upgraded (it is more likely with a patch pump than with a tubey one) . Are you likely to get a CGM or not? This may influence your decision because the T-Slim works with the Dexcom.

One small not of caution: if you diabetes team are going to put in an individual funding request, there is a possibility the request will be declined. I hope not but you need to be prepared for a bean counter who has never met you to decide you don't qualify. Fingers and toes crossed this does not happen to you.


----------



## Lily123

As I’m under paediatrics then I should automatically get the Dexcom or Libre 3 when the CCG can afford to implement the new guidelines (hopefully) I have lost a lot of faith in Libre after 2 sensors were extremely inaccurate within 24 hours on each other. I was speaking to the rep from Omnipod and he did say that because the pods are disposable that when the Omnipod 5 came out I would be immediately upgraded. With the Dana I it seems good because of the ability to control it from your phone but the downside is that CamAPS only works with Android and I have an iPhone.


----------



## SB2015

Sounding promising @Lily123 
Sorry that I can’t help with any of the pumps on your list.


----------



## rayray119

Lily123 said:


> I went to the pump & and technology info day today and have narrowed down my choice to: Omnipod dash, Dana I or T:slim. Any thoughts?
> 
> And because I don’t meet the guidelines the diabetes team are most likely going to put in a individual funding request


hope it works out for all out for you.  i can't sujuest anything as i'm not a pump myslef and plus been dinosgged for a much shorter time then you.


----------



## Inka

Lily123 said:


> I went to the pump & and technology info day today and have narrowed down my choice to: Omnipod dash, Dana I or T:slim. Any thoughts?
> 
> And because I don’t meet the guidelines the diabetes team are most likely going to put in a individual funding request



The right/best pump is the one that’s right for you @Lily123 Other people might have different needs and different priorities and preferences.

Think about your lifestyle. Write down the features of each pump and circle anything worrying or anything extra-good. Remember too that cannulas are very important and often neglected. It’s no good having the world’s most advanced pump if the crucial interface with your body (the cannula) is crap or doesn’t suit you. Personally I’d never go for a pump which didn’t have a choice of cannulas, and I’d never go for a pump that had cheapy or dodgy cannulas. Make sure your chosen pump fulfils all the criteria: good pump for you, good cannula choice, good customer service.

I’d choose the Dana out of those, as you probably guessed. You can get a cheap Android phone if that’s an issue. I don’t loop with mine.


----------



## Lily123

Inka said:


> The right/best pump is the one that’s right for you @Lily123 Other people might have different needs and different priorities and preferences.
> 
> Think about your lifestyle. Write down the features of each pump and circle anything worrying or anything extra-good. Remember too that cannulas are very important and often neglected. It’s no good having the world’s most advanced pump if the crucial interface with your body (the cannula) is crap or doesn’t suit you. Personally I’d never go for a pump which didn’t have a choice of cannulas, and I’d never go for a pump that had cheapy or dodgy cannulas. Make sure your chosen pump fulfils all the criteria: good pump for you, good cannula choice, good customer service.
> 
> I’d choose the Dana out of those, as you probably guessed. You can get a cheap Android phone if that’s an issue. I don’t loop with mine.


I’m leaning towards Omnipod so dance and PE don’t cause issues with tubing but the only issue I have with it is that you can’t tell if the cannula gets kinked


----------



## Saoirse

Lily123 said:


> As I’m under paediatrics then I should automatically get the Dexcom or Libre 3 when the CCG can afford to implement the new guidelines (hopefully) I have lost a lot of faith in Libre after 2 sensors were extremely inaccurate within 24 hours on each other. I was speaking to the rep from Omnipod and he did say that because the pods are disposable that when the Omnipod 5 came out I would be immediately upgraded. With the Dana I it seems good because of the ability to control it from your phone but the downside is that CamAPS only works with Android and I have an iPhone.


If it helps I've recently been through the same though process.  Would love an omni but my clinic don't support it for adults on cost grounds, which left t slim and dana (i dismissed ypsomed and medtronic).  My priorities were: discrete, controlled by phone, loop able - I asked to go into clinic so I could pick them up and get a feel for them.  Ultimately, the fact t slim is not controllable from a phone and needs charging regularly were 2 big negatives for me.  I also dance a lot and don't fancy fishing around in my clothes for a pump.  So I chose dana because it feels light and small, can be tucked away and I plan to loop with camaps.  I haven't had pump stat yet, so who knows if it was the right choice, but something that a number of people said was basically, it's your first pump, odds are you will love it anyway   Good luck with the decision.


----------



## nonethewiser

Lily123 said:


> I’m leaning towards Omnipod so dance and PE don’t cause issues with tubing but the only issue I have with it is that you can’t tell if the cannula gets kinked



Don't worry about that, there's viewing window to check if cannula is inserted correctly, plus manufacturer recommends that you check bg 90 mins after application to see if all is well.

I've  never had kinked cannula & only couple of blocked cannula messages where had to change pod.


----------



## Lily123

nonethewiser said:


> Don't worry about that, there's viewing window to check if cannula is inserted correctly, plus manufacturer recommends that you check bg 90 mins after application to see if all is well.
> 
> I've  never had kinked cannula & only couple of blocked cannula messages where had to change pod.


Thanks,that’s reassuring. How long have you been using Omnipod?


----------



## nonethewiser

Lily123 said:


> Thanks,that’s reassuring. How long have you been using Omnipod?



Roughly around 9 years, only switched to Dash device last year.


----------



## Squirrel768

Lily123 said:


> Yeah I’m using half unit pens. I used to have different colour pens for the NovoRapid and Tresiba but on the old pen I used for Tresiba the end was that stiff I couldn’t do my own injection. So there both dark blue only a few times have I nearly done 23.5 units of NovoRapid instead of Tresiba!


@Lily123 I know what you mean with the wrong insulin. Befor I switched to Tresiba I had a split dose of Levemir, and my trick at bedtime was to grab the wrong pen! Not so bad when I realised, but not good when I didn't notice! Switching to a single Tresiba in th morning was great, as I was then taking both. 

Now on Omnipod pump, so that was a whole new learning curve LOL, but well worth it.  Very happy with the pod and lack of tubes ... and no need to disconnect the pump for bathing or swimming


----------



## Lily123

Squirrel768 said:


> @Lily123 I know what you mean with the wrong insulin. Befor I switched to Tresiba I had a split dose of Levemir, and my trick at bedtime was to grab the wrong pen! Not so bad when I realised, but not good when I didn't notice! Switching to a single Tresiba in th morning was great, as I was then taking both.
> 
> Now on Omnipod pump, so that was a whole new learning curve LOL, but well worth it.  Very happy with the pod and lack of tubes ... and no need to disconnect the pump for bathing or swimming


Only problem with Tresiba is that if you completely forget to take it then you don’t realise because it lasts longer than basals like Levemir and Lantus


----------



## helli

Lily123 said:


> Only problem with Tresiba is that if you completely forget to take it then you don’t realise because it lasts longer than basals like Levemir and Lantus


I don't think that is a problem. It gives you a bigger window to remember.

The problem is the inflexibility. You cannot change the dose due to exercise or monthly hormones. And, you have to know days in advance that you are going to be unwell and need extra basal.


----------



## rayray119

helli said:


> I don't think that is a problem. It gives you a bigger window to remember.
> 
> The problem is the inflexibility. You cannot change the dose due to exercise or monthly hormones. And, you have to know days in advance that you are going to be unwell and need extra basal.


Yeah then if need to make a more permanent to change to have to wait for 3 days before you can get an idea if it's working or not.


----------



## rayray119

Squirrel768 said:


> @Lily123 I know what you mean with the wrong insulin. Befor I switched to Tresiba I had a split dose of Levemir, and my trick at bedtime was to grab the wrong pen! Not so bad when I realised, but not good when I didn't notice! Switching to a single Tresiba in th morning was great, as I was then taking both.
> 
> Now on Omnipod pump, so that was a whole new learning curve LOL, but well worth it.  Very happy with the pod and lack of tubes ... and no need to disconnect the pump for bathing or swimming


did you feel like you forotten do something when you first started on the omimpod


----------



## rayray119

Lily123 said:


> You didn’t get a no then so that’s good. Maybe the new consultant with be more open minded


So the the new consultant I'm on the waiting list to see is a type 1 dibitic herself that might work in my favour


----------



## Lily123

rayray119 said:


> So the the new consultant I'm on the waiting list to see is a type 1 dibitic herself that might work in my favour


Possibly


----------



## Bruce Stephens

rayray119 said:


> So the the new consultant I'm on the waiting list to see is a type 1 dibitic herself that might work in my favour


Shouldn't hurt. Especially if she uses a pump herself.


----------



## rayray119

Bruce Stephens said:


> Shouldn't hurt. Especially if she uses a pump herself.


It will probably actually be helpful to be under her pump or not pump.


----------



## trophywench

One of the nurses at our GP surgery was T1.  She was pretty clueless, frankly.  She attended a nearby hospital for her D care and said they were useless as they hadn't managed to cure her night-time hypos .....  Err, hang on - that's your job you twit, not theirs .....  Zipped my lip.  No point having a battle with an unarmed opponent.


----------



## rayray119

trophywench said:


> One of the nurses at our GP surgery was T1.  She was pretty clueless, frankly.  She attended a nearby hospital for her D care and said they were useless as they hadn't managed to cure her night-time hypos .....  Err, hang on - that's your job you twit, not theirs .....  Zipped my lip.  No point having a battle with an unarmed opponent.


Ah yes but this a diabetties consuldent not a standard go nurse.


----------



## trophywench

Yes - but I never make assumptions because making them can so easily make an ass out of u and me!


----------



## Squirrel768

Lily123 said:


> Only problem with Tresiba is that if you completely forget to take it then you don’t realise because it lasts longer than basals like Levemir and Lantus


I never found that to be a problem, as I always did my Tresiba at breakfast, so it was a dose of Novarapid, and a dose of Tresiba. Just getting into the routine, and avoided the problem of forgetting, or taking the wrong one, at bedtime. As @helli said, you couldn't change the dose easily, but I found that having the longer acting (42 hours) of basal, and having it at breakfast, it meant that I had effectively a reduced dose overnight as the first overlapping dose phased out, but maintained a steady basal during the day. Any adjustments were done with reducing or increasing the bolus.


----------



## Squirrel768

rayray119 said:


> did you feel like you forotten do something when you first started on the omimpod


Not really - I had been pushing to get onto a pump for a while. I was hoping for the Tandem, but there was a delay at my clinic making it available, so I settled for the pod instead. Advantages are being tubeless, and not having to fiddle around filling the tubing, plus it stays on when I shower etc. Initiating it is very straightforward - draw up insulin, deactivate the current pod, inject insulin into the pod, and start the activation process, then attach to the chosen body part. Downside initially was that there was absolutely zero option of a closed loop for it initially, but then I found out that the forthcoming release of Android APS DIY system (3.0.0.1) would be facilitating looping the Dash, which I am now doing.


----------



## Lily123

Squirrel768 said:


> I never found that to be a problem, as I always did my Tresiba at breakfast, so it was a dose of Novarapid, and a dose of Tresiba. Just getting into the routine, and avoided the problem of forgetting, or taking the wrong one, at bedtime. As @helli said, you couldn't change the dose easily, but I found that having the longer acting (42 hours) of basal, and having it at breakfast, it meant that I had effectively a reduced dose overnight as the first overlapping dose phased out, but maintained a steady basal during the day. Any adjustments were done with reducing or increasing the bolus.


Yes and the time I take Tresiba varies between weekday and weekend because I take it before bed but that doesn’t always mean I remember


----------



## Squirrel768

Robin said:


> I ended up with two dark blue pens at one point, so I stuck a label on the basal pen and wrapped it with sellotape, and I got to know instinctively that the Levemir pen had a rough bit on it, and the novorapid was smooth. Now I’ve got a red one for bolus, but the label is still on the blue one, which helps first thing in the morning if it’s a bit dark!


I used to have a red (for rapid) and a silver (for slow) but then when I needed to replace them I ended up with two the same!


----------



## Squirrel768

Lily123 said:


> Yes and the time I take Tresiba varies between weekday and weekend because I take it before bed but that doesn’t always mean I remember


Ah - that is the very reason I went on to taking mine at breakfast - start of the day as part of the breakfast routine. Avoided any night time mishaps! However, I've had many more years of practice at screwing up my doses than you have LOL.


----------



## rayray119

Lily123 said:


> Yes and the time I take Tresiba varies between weekday and weekend because I take it before bed but that doesn’t always mean I remember


When I was on tresibra I used to take it when I got up but one morning I think I spit all of it because it hadn't got needle in probelly (early days) but saw no difference and was still hypoing in the day was on set doses a point well that night I was shooting up


----------



## Lily123

I don’t think switching to take Tresiba in the morning would help - half asleep teenager just about capable of getting up let alone remembering an injection LOL


----------



## Lily123

Update: Still haven’t got funding but the DSN was off from about June until December with an injury so that’s fair enough.

Had an appointment with the diabetes nurse today and she made some suggestions for the night hypos - dropping the basal down to 21. Also mentioned about at the next appointment or after dexcom funding has gone through I’d need an appointment with her and the psychologist before they put the funding request in


----------



## Proud to be erratic

Lily123 said:


> I don’t think switching to take Tresiba in the morning would help - half asleep teenager just about capable of getting up let alone remembering an injection LOL


Yes, love the humour!
Realise you replied in May, just caught up! Also with Tresiba the timing is far less important; today's dose is topping up yesterday - given the 40 hour profile of Tresiba


----------



## Proud to be erratic

Lily123 said:


> Update: Still haven’t got funding but the DSN was off from about June until December with an injury so that’s fair enough.
> 
> Had an appointment with the diabetes nurse today and she made some suggestions for the night hypos - dropping the basal down to 21. Also mentioned about at the next appointment or after dexcom funding has gone through I’d need an appointment with her and the psychologist before they put the funding request in


One thing that has also changed in the last 12 months is the reorganisation of NHS the former quite small CCGs (Care Centre Groups - which oversee GP Surgeries and provide funding allowances for Hospital Trusts and Surgeries).

Since 1 July 2022 the CCGs have been grouped together into much larger Integrated Care Systems (ICS). My South Bucks region is now part of a Bucks, Oxford and Berkshire West (BOB) Region, embracing c.140 former CCGs. Not sure if your part of Bucks is within the new BOB. But in due course each large ICS will be dictating what can and can't be provided by all Trusts and Practices in their Region. I'm not clear how much "integration" has already happened and certainly in the BOB ICS there is clear evidence that the reorganisation is providing an excuse to defer and delay implementation of anything that needs extra funds!

You can't do much about this, but might be worth you being aware that this could occur. If I were in your situation I'd politely but robustly pester for your case to be dealt with promptly - before it gets bogged down in the bigger picture of Reorganisation!


----------



## Lily123

Proud to be erratic said:


> One thing that has also changed in the last 12 months is the reorganisation of NHS the former quite small CCGs (Care Centre Groups - which oversee GP Surgeries and provide funding allowances for Hospital Trusts and Surgeries).
> 
> Since 1 July 2022 the CCGs have been grouped together into much larger Integrated Care Systems (ICS). My South Bucks region is now part of a Bucks, Oxford and Berkshire West (BOB) Region, embracing c.140 former CCGs. Not sure if your part of Bucks is within the new BOB. But in due course each large ICS will be dictating what can and can't be provided by all Trusts and Practices in their Region. I'm not clear how much "integration" has already happened and certainly in the BOB ICS there is clear evidence that the reorganisation is providing an excuse to defer and delay implementation of anything that needs extra funds!
> 
> You can't do much about this, but might be worth you being aware that this could occur. If I were in your situation I'd politely but robustly pester for your case to be dealt with promptly - before it gets bogged down in the bigger picture of Reorganisation!


I think I’m under South Bucks as I live in North Herts so location wise it makes sense. 
The diabetes nurse sent the notes from the appointment over email yesterday and said that there just needs to be a date set to meet with both her and the psychologist and then they can apply for pump funding


----------



## ChristineBee

Sorry to jump in, but my hospital had three pumps on offer for my upgrade. 
I didn’t want any of them, I only wanted the Mylife ypsomed pump (I’m currently upgrading from the Insight. )
My hospital accommodated my request. I’m going to be the only one using it. 
I think it’s worth checking them all out and asking if you prefer one that isn’t on the list. 
I too was offered T:Slim, omnipod and the Medtronic. 
I didn’t fancy any of them after thoroughly researching. 
The Ypsomed is currently the only pump that uses pump cartridges (like the insight), that and its simplicity and small size swayed me. 
Good luck!


----------



## Lily123

My hospital doesn’t offer Ypsopump but I hope it works out for you!

I was looking at Dana but after speaking to the diabetes nurse yesterday she said they had a lot of problems with it. She said to go and research the Tslim as it is the one that has worked well for most people on pumps at my hospital and they hadn’t had any issues with it


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## helli

I have always had a pump that requires me to fill the cartridges. This is by far my preference because it allows me to put as much insulin as I will need in each set change rather than throwing out a half full cartridge.
In my experience, filling pump cartridges has always been simple and problem free.
I can understand the fear of doing it, especially after watching some videos. But in reality, you soon get used to it.


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