Insulin Pumps and how do you get one?

Bifforod

The big issue is that the Medtronic Minmed pump is that it does not warn of non delivery of insulin. How do the other products fair in this regard.

eilo1

http://a6.sphotos.ak.fbcdn.net/hphotos-ak-ash4/373772_10150528220476255_732146254_10604999_1420166507_n.jpg

CramCycle

robinph wrote: »

That sucks.

And they told me to drop my Glargine quite a bit, I argued but got the impression it would help my case if I was more forthcoming so agreed to, bloods have been through the roof for a few days.

Needless to say, my general good humour has taken a nosedive as witnessed by both my work turnover, my general attitude and the number of bans/infractions handed out over on the cycling forum :eek: My cycling has also taken a hit but I partly blame the wind.

Getting it back to normal today (reduced food, slight increase in Glargine and novo) but barely, still feel a bit on the off side.

On the plus side, I'll be with the system I know over christmas but I want to get it ASAP after as I have started my training for next year and want to get it the earlier the better.

eilo1

Bifforod wrote: »

The big issue is that the Medtronic Minmed pump is that it does not warn of non delivery of insulin. How do the other products fair in this regard.

There is an alarm on the pumps that says "no insulin delivery" but for some reason it does not pic up the delivery issue when it is kinked.

eilo1

CramCycle wrote: »

And they told me to drop my Glargine quite a bit, I argued but got the impression it would help my case if I was more forthcoming so agreed to, bloods have been through the roof for a few days.

Needless to say, my general good humour has taken a nosedive as witnessed by both my work turnover, my general attitude and the number of bans/infractions handed out over on the cycling forum :eek: My cycling has also taken a hit but I partly blame the wind.

Getting it back to normal today (reduced food, slight increase in Glargine and novo) but barely, still feel a bit on the off side.

On the plus side, I'll be with the system I know over christmas but I want to get it ASAP after as I have started my training for next year and want to get it the earlier the better.

Sorry to hear that Cram cycle! Its very unfair that you wont be getting one anytime soon. Fingers X for a change of heart in the HSE soon!

robinph

Actually, I have had one kinked canula. But it didn't actually cause an issue with delivery and I only noticed it when I was changing sets as normal and just saw it as a bit strange. I've never had any alarms at all from my pump yet, except for battery and low insulin left in the cartridge.

I think that the other people who started on the same pump as me at the same time, so I've met them again at a couple of appointments, have had a few alarms go off on their Animas pumps so I have faith that it does alarm for non-delivery. Just I've been lucky so far.

robinph

CramCycle wrote: »

And they told me to drop my Glargine quite a bit, I argued but got the impression it would help my case if I was more forthcoming so agreed to, bloods have been through the roof for a few days.

Needless to say, my general good humour has taken a nosedive as witnessed by both my work turnover, my general attitude and the number of bans/infractions handed out over on the cycling forum :eek: My cycling has also taken a hit but I partly blame the wind.

Getting it back to normal today (reduced food, slight increase in Glargine and novo) but barely, still feel a bit on the off side.

On the plus side, I'll be with the system I know over christmas but I want to get it ASAP after as I have started my training for next year and want to get it the earlier the better.

Thanks for the warning about steering clear of the cycling forum for a bit.

I think that you do have to just do whatever they say to a certain extent before they put you forward for the pump. It isn't good that you thought you were already in line for one though and then they seem to have put a delay on things. Jump through whatever hoops they put infront of you, keep pushing the idea of the pump in the mean time.

I don't think that everyone should get a pump straight off, because it is essential that we know how to deal with MDI as well, but I do think that they are so good a change to the way insulin is delivered to your system that it is something basically everyone should be moved to in time. They are especially useful for being active as well and the cycling angle may help a bit if you push that, I think my racing and marathon running may have helped a little with my getting approval.

Hard to know exactly what is needed to get a pump though. Maybe after 15 pages of posts we should have figured it out in this "How to get a pump" thread?

CramCycle

robinph wrote: »

Thanks for the warning about steering clear of the cycling forum for a bit.

Should be safe by Friday

I think that you do have to just do whatever they say to a certain extent before they put you forward for the pump. It isn't good that you thought you were already in line for one though and then they seem to have put a delay on things. Jump through whatever hoops they put infront of you, keep pushing the idea of the pump in the mean time.

I get the impression that I am only being told what to do so they can improve my control without a pump and then say, well you don't need one, I presume due to funding. My control isn't perfect but it isn't bad either, I went off the rails over the Summer, they said to reach goal A, I reached it, now they want Goal A+, I guess when I hit that it will be A++

I don't think that everyone should get a pump straight off, because it is essential that we know how to deal with MDI as well, but I do think that they are so good a change to the way insulin is delivered to your system that it is something basically everyone should be moved to in time.

I agree, everyone should get used to injections and dealing with it the old fashioned way as you never know what situation you may get stuck in, I was quite surprised at the number of children getting approved considering they would not have gone through the joy of Adolesence yet or possibly not even over their honeymoon period yet.

They are especially useful for being active as well and the cycling angle may help a bit if you push that, I think my racing and marathon running may have helped a little with my getting approval.

I am back in on the 24th of January, I think the 3 to 4 days without sleep during a competition may help my case but we shall see.

Hard to know exactly what is needed to get a pump though. Maybe after 15 pages of posts we should have figured it out in this "How to get a pump" thread?

At this point i think it is a waiting game, currently I am trying to see can I get one through work (amazon and ebay were a bust :eek:) and if I am refused again I may go that route if it can be done, just have to figure out the angle for a funding proposal, suggestions welcome :pac:

NB The above is a lie, ethics would never clear it but if they could.

eilo1

Does anybody have any ideas as to what could be going on here??

I stated above that I keep having days were massive sugars come out of nowhere and today is a perfect example.

I woke up at 5.30 and was 16.3 took a correction of 3.3 plus one cp and one more unit.
8.10am I had a toasted sambo (chicken, cheese, sweetcorn) and took 4.2 units. I can be a little resistant in the morning so took 0.7 units more than the 3.5 I normally would take on a one to one ratio.

13.30 I had a small roll the soft type and I took 3 units.

I just did a test there at 14.30 because I dont feel great and low and behold Im 27.5. Great I just took 6 units to try and get this down.

I havnt eaten enough food today to be that high unless I have had no insulin at all!!

graflynn

eilo1 wrote: »

Does anybody have any ideas as to what could be going on here??

I stated above that I keep having days were massive sugars come out of nowhere and today is a perfect example.

I woke up at 5.30 and was 16.3 took a correction of 3.3 plus one cp and one more unit.
8.10am I had a toasted sambo (chicken, cheese, sweetcorn) and took 4.2 units. I can be a little resistant in the morning so took 0.7 units more than the 3.5 I normally would take on a one to one ratio.

13.30 I had a small roll the soft type and I took 3 units.

I just did a test there at 14.30 because I dont feel great and low and behold Im 27.5. Great I just took 6 units to try and get this down.

I havnt eaten enough food today to be that high unless I have had no insulin at all!!

It could be lots of things. Start with your pumps user manual checklist to make sure it's not your pump first.

The next thing I would look at is to do more bg tests to determine whether it's your basal or bolus doses that are off.

Let us know how you get on.

eilo1

graflynn wrote: »

It could be lots of things. Start with your pumps user manual checklist to make sure it's not your pump first.

The next thing I would look at is to do more bg tests to determine whether it's your basal or bolus doses that are off.

Let us know how you get on.

Thanks Graflynn,

I had a continuous blood glucose monitor in place over the summer and the results indicated that my basal was very good. Also my over nights are normally good. For example thursday morning was 6.1 and Wednesday was 5.6.
The only thing I can think of is that Im doing exams at the minute and as such have not done any exercise or work (physical job) in a week. So maybe Im becoming a bit resistant because of that.

The 6 unit correction I took only brought me back to 14.0 I just took another 2 units to get this down further.

As to your advise on the pump that made me remember there is a self test button so I have just hit that, fingers crossed it comes up with something!

robinph

If I go more than a couple of days in a row without doing any running then my levels will start to go high more than normal and not correct with the normal correction boluses. Sounds like you maybe need to up the basal a bit for whilst your not being quite as active as normal.

Bifforod

Sorry to hear your sugars are off scale Eilo. I'm sure you have already but check for a kink in your cannula. Spoke to the nurse in Tallaght where my daughter is attending and she said there has been a lot of issues with the medtronic sets. They are sending out a new type to us to trial. Its hand fitted, I believe you slide the insert into the skin. Hope it cuts out the failures.

eilo1

Bifforod wrote: »

Sorry to hear your sugars are off scale Eilo. I'm sure you have already but check for a kink in your cannula. Spoke to the nurse in Tallaght where my daughter is attending and she said there has been a lot of issues with the medtronic sets. They are sending out a new type to us to trial. Its hand fitted, I believe you slide the insert into the skin. Hope it cuts out the failures.

Thanks i did change the set and im back down to 6 now thankfully :-) although the set had been in for two days and i came down to 14 before i changed sets.
that pump sounds interesting im going to download all my info and have a serious chat with my team in January.

Who is your nurse in tallaght? When i was there i as under adriane and i loved her!!

@ robin thanks for the advice i agree the exercise might account for some of this. Iv anonther exam tomorrow so i will put my background up 10%and see how i get on. ;-)

Bifforod

Yes its still Adriane and she'sstill as popular as ever. good to hear your back in control.

Adventure Pout

Just found that thread..as i am sooo interested in getting a pump. Am at Mater and for the last 4 or 5years I have been requesting for one but the 1st consultant i met, was an absolute a$$ :mad::mad: to me, then I asked one of the nurse who did not know much about it.. When i go to my appointments, i asked whoever junior dr about it, and they seemed either not to know or to care to provide me one.. All my blood tests are good, last hba1c was 6.1. Have diabetes for 27 years now and am getting sick and tired of injecting..
If i was in France, Belgium or Germany, they would have given me the pump long time ago without any arguments!! I was one of the first patient in France to test the first insulin pump when I was kid, but it did not suit back then..
Any advices on how i can get the Mater to give me one will be more than appreciated

robinph

Before I got too carried away with the drinks last night someone was pointing in my approximate direction and repeatedly asking me "What is that?". It took me a while to figure out that they were on about my pump. Quite pleased with myself actually that as it's now such a normal part of me I couldn't figure out what they were on about or pointing at.

Think I then bored them senseless with explaining it and they regretted asking the question though.

mak78

CramCycle wrote: »

At this point i think it is a waiting game, currently I am trying to see can I get one through work (amazon and ebay were a bust :eek:) and if I am refused again I may go that route if it can be done, just have to figure out the angle for a funding proposal, suggestions welcome :pac:

Didn't I see on the cycling forum that your thinking of doing Race Around Ireland this year? Why not contact Medtronic Ireland about sponsorship including a free pump & supplies? They might sort you out for a pump and who knows they might even help towards costs of RAI if they get some publicity out of it.
The TT1 guys have Sanofi-Avensis plastered all over their jerseys so why not ... ?

On a slightly different (but closely related) topic, are the HSE providing CGMs readily at the moment or is it same situation as the pumps? Would like to get a better solution for testing while running/cycling. Just did a race over xmas and cost me around a minute at half way point fiddling around for a test strip and testing.

CramCycle

mak78 wrote: »

On a slightly different (but closely related) topic, are the HSE providing CGMs readily at the moment or is it same situation as the pumps? Would like to get a better solution for testing while running/cycling. Just did a race over xmas and cost me around a minute at half way point fiddling around for a test strip and testing.

Won't be happening anytime soon and even with a CGM you would probably still need to test at any slight off feeling. Great for trends and long term adjustments, seeing the things on the spot tests miss but they also miss what on the spot testing sees by about 20 minutes if I recall correctly.

robinph

mak78 wrote: »

On a slightly different (but closely related) topic, are the HSE providing CGMs readily at the moment or is it same situation as the pumps? Would like to get a better solution for testing while running/cycling. Just did a race over xmas and cost me around a minute at half way point fiddling around for a test strip and testing.

My method, which would almost certainly not be recommended by the diabetes nurse, has just been based on guesswork essentially, but I've never stopped part way through a run to do a test. From testing before and after training and gradually learning what BG level will allow me to keep going for X amount of time I do manage to get around marathons without testing, and then having a BG of about 7 at the finish line. I've also done a lot of trail and error with figuring out how many and often I need to take gels on the way round.

When on MDI I had to take a gel every 20 minutes from the start of a run if the total time was to be over an hour, that makes for a lot of gels by the end of a marathon. :eek:
With the pump and turning down the basal I would still be taking a gel every 40 minutes.

I have had pretty good sense of when hypos are coming on, but it is a bit harder to tell after you've been out training for a while and having to spot the difference between a hypo and just the feeling of having done some exercise.

mak78

Thanks for the CGM info guys. Looks like I'll need to stick with combination of test strips and gut feeling for a good while more

robinph

Sat in the airport waiting for a very early flight to go skiing, and I've just remembered that I should have called the pump company about getting a spare unit to take away with me. Guess this will be a good test of how tough this Animas pump actually is. I don't intend to crash into too many trees with it, but you never know. The cold will be a good test if nothing else.

robinph

robinph wrote: »

Well that wasn't so bad after all, although the complicated stuff actually doesn't start 'till next week.

Was four of us starting on the pump together, well one woman had already been on a Minimed for 6 years until it broke so was just there for training on the Animas really.

We got show through setting up all the various menus, although there seems to be quite a bit more we didn't delve into just yet. Lots of alarms going off at various points as the new pumps all complained about not quite being setup right yet so learning what all those settings were about. Then we played with a few of the different types of canulas.

None of us seemed particuarly keen on the metal canula option, but we all fitted one of them first. This is the white patch on the bottom right of the picture and that the cableing is actually connected to at the moment. It is just inserted the same as a regular needle, just you then leave it there. It actually connects/ disconnects to the pump at the sticky pad just above it on the top rightof my belly. It wasn't any bother to put it in and I cannot feel it at all now.



The blue thing on the left of the picture is a 90 degree plastic canula. I've just left that in for now to see how it feels as well. It has a fancy package it comes in which fires it into you. It doesn't hurt, but you can notice it for a couple of minutes afterwards, but that is just down to the insertion method as I cannot feel it any more now.

There was also a plastic 30 degree one they gave us as well, but I was then running out of places to stick them so just fired that device into some foam. I'll be trying that one out over the weekend though just to see how it feels for me and then on Monday I go to get setup with insulin and pick which type of canula I want to go with.

I expect I'll go with the plastic 90 degree one, although not in the pink models that he has given me to practice with. Just have to try not to strangle myself in cabling overnight and mess around with the various menus a bit more whilst it's only saline that I'm pumping into myself.

One year ago on, and I almost forgot.

robinph

Fellow pumpers...

I've done plenty of getting through airport security with the various sharps in my bag and now the pump attached to me a few times as well and generally have no problems, apart from incompetent UK security. I'm about to head off again next week and this time remembered to request a back up loaner pump from Animas before going away, so I'm going to have to carry that through the arch in my hands.

Any tips on how to deal with the security person at the "put everything in the tray" point? With the pump attached to me it's quite obvious from me just showing them the canula that it ain't going through the metal detector with me plugged into it, but how much explaining do you need to do for the pump that you have in your hand and do they get all freaked out about it?

Will be going through Greek, probably German, and more worryingly UK security. I printed out a Google translate of the letter from Animas explaining what the pump is, but as the alphabet is not even the same it could be saying absolutely anything.

graflynn

robinph wrote: »

Fellow pumpers...

I've done plenty of getting through airport security with the various sharps in my bag and now the pump attached to me a few times as well and generally have no problems, apart from incompetent UK security. I'm about to head off again next week and this time remembered to request a back up loaner pump from Animas before going away, so I'm going to have to carry that through the arch in my hands.

Any tips on how to deal with the security person at the "put everything in the tray" point? With the pump attached to me it's quite obvious from me just showing them the canula that it ain't going through the metal detector with me plugged into it, but how much explaining do you need to do for the pump that you have in your hand and do they get all freaked out about it?

Will be going through Greek, probably German, and more worryingly UK security. I printed out a Google translate of the letter from Animas explaining what the pump is, but as the alphabet is not even the same it could be saying absolutely anything.

I usually just disconnect and put is though the xray machine. I know that Animas says not to but I prefer the easier life and have had not issues with the effectiveness of my pump. I've been pumping for almost 2 years and travelled through security screening about 3-4 times.

CramCycle

In fairness to most airport security personnel, they recognise Diabetes equipment easily, other than accepting you will have to take a pat down every time through the metal detector and having the letter in your hand, it should be fine (he says with no experience whatsoever).

If you are worried about the google translate, make sure you have the english one to hand as well, high chance one of the members of staff will have a bit of english (look at me, i am an ignorant foreigner who expects everyone to speak my language :eek: )

robinph

It's actually the UK security I'm expecting to be more awkward.

If they have noticed the pump on my belt before going through the arch then they have been fine with it mostly so far. A Dublin airport person shouted across to her security counterpart on the airside of the arch "He's got one of them things on" last time I went through, caused a couple of confused looks from other passengers. It's just the carrying another gadget in my hands that looks more obviously strange and wondering how they react.

Have to say that I'm impressed with the speed and service that Animas got a spare pump out to me, and the letter specifically for the security is a useful touch. It's a bit long for anyone to bother reading though unless you get taken aside to a room and they break out the rubber gloves. :eek:

CramCycle

robinph wrote: »

If they have noticed the pump on my belt before going through the arch then they have been fine with it mostly so far. A Dublin airport person shouted across to her security counterpart on the airside of the arch "He's got one of them things on" last time I went through, caused a couple of confused looks from other passengers. It's just the carrying another gadget in my hands that looks more obviously strange and wondering how they react.

Just wondering why you don't put the spare through the x ray machine? or is this the one that is attached to you? Sorry, very confused as to why you are holding it in your hands.

I know I am missing something obvious but I thought I'd ask.

robinph

The letter that they give use specifically says not to put it through the xray, it also had mention of that in the letter I had to sign and send back to them saying they could charge me for it if blah blah blah... I think, but didn't take a copy of that one.

I did think before hand that the spare could be put through when not powered, but seems they are a bit nervous about the thing getting screwed up when people are away so managed to get the TSA to allow them to not go via the xray machine. Seems that the link they provide in the letter to the TSA website pdf is broken, but anyway...

I'll have some fun and try not to cause any international incidents.

robinph

Just noticed this morning that I'd not changed the clock on my pump. Doh!