It must've been during one of the last Diabetes appointments for me at my old clinic, before I threw my toys from the pram and transferred all my care to my GP, because the memory of the event is very hazy. The numbers weren't looking great, I wasn't feeling great, volunteers were wandering around and making small talk - which added to my tension and it was waiting room temperatures in there.
"We could try you on a pump"
Have something attached to my stomach? 24 hours a day!? The idea was dismissed by me immediately and probably not in the kindest of tones to that HCP. What an idiot.
Here we are, probably 20 years later, and I would crawl through fire to trial an insulin pump. In fact, what I've agreed to do might feel like crawling through fire but I'm going into this with an open mind, a clean slate, no judgements... at least none that I'll verbalise until it's over.
I got pump-curious after meeting so many #GBDoc folk, hearing their stories and wondering if that might work for me. I've carefully listened to their joys and woes and after many tweets and many messages I decided to make some noise about it to my consultant. We'd spoken about it in 2019 but my A1c was great, I wasn't really struggling with anything which might make pumping a priority and I felt the appointment time would be better served by bringing up Libre access. So it proved, although Libre funding wasn't straightforward and took some intervention by Prof. Partha Kar to make it happen.
This time! There will be no name dropping, string pulling or threats (just kidding). I'm going through the process as an ordinary Diabetic. I am, after all, an ordinary Diabetic as I've mentioned many times. I'll create a blog for each step of the process in moving from MDI to pumping, you'll hear about everything and this is Part 1.
The conversation with my consultant went exactly how I want every appointment to go. I know that I'm doing alright, I'm getting by, and once that had been confirmed I brought up the subject. I know it's not a case of ask and you shall receive with the NHS. The money pot is not an endless one and criteria has to be met and I think that's fair enough. I'm not here to abuse the system. I genuinely think pumping could take my T1D management to the best place it could be and here is why:
- Dawn phenomenon
- Impaired hypo awareness
- Injection burnout
- MDI & CGM (or Flash) use has reached it's limits in improving my Diabetes management
and a quick look at the details for those four points? Sure, okay.
There is only one Phenomenal Dawn and that's @MoodWife. Dawn Phenomenonononon is really annoying and has begun happening to me more frequently despite Basal changes and tweaks. It's affecting my Time In Range and increasing my average blood glucose level and, of course, my HbA1c.
My hypo awareness is cancelled. In the last 5 years, I've gone from feeling hypo at 6mmol (when my BGs were too high) to feeling hypo at 4mmol (Yay!) to feeling hypo-ish at 3mmol and only having the strong feels when the number is low 2mmol. Worrying stuff, right? I'm glad I'm CGM'd up to the eyeballs and that I have alerts for falling BG otherwise you may have seen dramatic images of me in hospital. My hypos tend to happen when I'm asleep and my alarms usually wake me. However! sometimes they don't until things are very urgent. Worrying stuff again, right? My overnight BGs are a mess and it would be wonderful to have a pump provide more stability.
I inject at least 7 (SEVEN!) times per day. That can rise to 10 if things are really bouncy! and I'm becoming increasingly tired of the burden of it all. The idea of changing a canula twice in six days, compared to possibly 60 injections in that time, sits very pretty in my mind. That would represent a huge decrease in my Diabetes burden and a better QoL.
My overall management of my condition is very good. "You have very good control", said my consultant. I know, I'm kind of a big thing. I have many leather-bound books and my apartment smells of rich mahogany. 60% of the time, it works every time... I'll stop with the Anchorman stuff now (watch the movie and think of me). I know that I'm doing alright but I know it could be better. It can't be better with my current therapy. That can only happen via technology or I will likely suffer from burnout by trying any harder.
So, those points were put across and! it seems I'm good to go... good to go to DAFNE. Remember earlier when I mentioned crawling through fire? That's right! It's DAFNE time. Deep breaths. I know that it's been a great thing for many of you and in the interests of peace and ticking a box and being an ordinary Diabetic, I'm going to go through with it. And that's where I am, right now. I'm waiting for the call from the DAFNE lady, who I really hope is called Daphne, to begin the training process. When that happens I will publish Part 2. I bet you couldn't be more on the edge of your seat.
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