I am very excited that my discussion has led to so many responses and I really appreciate all of your opinions and advice. Learning about other country’s healthcare is important to me too for it helps with my opinion of my own.
I saw my Endocrinologist on Monday and she understood all of my concerns but I found out that I am “Basaled” way too high. My basal is 75% and so the swings in by BG’s have most probably been the result of that. I was getting help with my basal rate adjustments using the CGMS and a local physician. He was adjusting the basal rates according to the trends on my data graphs. I felt the insulin rate was too high as I have never in 14 years taken a basal rate of 1.2 units per hour (at times, I have other basal rates as well)
My Endo asked me if I felt like I was eating to feed my insulin and I said Yes!!
So I am sticking to the pump and CGMS for now. I will download my data from my pump and she will be able to access it and adjust my basal rate further. We will treat the lows first, then the highs…
she also informed me that the new Sensor, smaller and more sensitive to lows is at the FDA waiting for approval.
She said I could try MDI but would probably give up after 2 weeks since the glucose control would be harder.
If I did decide to use MDI I could even use the pump to only monitor my sugars through the sensor. I never thought of that.
As usual she renewed my strength by complimenting my hard work and excellent job.
All of my pump, BG sticks, meters,sensor and supplies are covered 100% with our insurance. My insulin has a copay but I can get a 3 month supply at a time.
My son thinks he may have diabetes but has no health insurance. Tthe place where he works does not offer insurance and so he has to purchase his own. Otherwise he has to pay for all of his doctor visits. He is young and up until now has had no health issues. He knows he will need to get insurance but I thought there was a new law protecting persons who have preexisting conditions. Maybe it is not yet in effect? 4475-Myphotos2010005.JPG (431 KB)
Of course you are not crazy. Minimed cgms is a virtual harpoon and painful for a lot of people. Some may have a higher pain threshhold than others. I would say go with the Dexcom. It does not even leave a mark half the time on the skin when you remove it. At some point everyone is going to have a problem with “real estate” on their body, so allowing your skin to heal might not be a bad idea. Since you can’t vary temp basal rates with Lantus and having a lot of lows, I would be concerned because of potential lows; hence the Dexcom suggestion. And, yes, I would test the pump; they can malfunction. Do what’s best for you. You can always take the pump out of the drawer and put it back on if you are not happy with the Lantus and Novolog.
I have been taking a break from it for 2 years. My old pump died and I was not really into it. The thing I did like about it was that you were able to make smaller adjustments to the dose.
You have to decide what works best for you and your diabetes. My type 1 is very specific to me and I have episodes that happen to me that I haven’t heard from others. And when I’m low, I lose my appetite, and when high, I get hungry. Totally opposite of what is written in books, and websites about the disease. So, I think it’s what works best for each individual person. Good luck. And…stay healthy,
MR.DR
I just watched a video demonstrating the Dexcom. I could not tell how large the needle was, but it looked about the same in the end. I know Medtronic is coming out with a smaller needle. But maybe it is wearing all of this hardware that is really getting to me not to mention everything you have to drag along when you travel.
Thanks for the tip…
Yes that ability and being able to reduse basal is one of the pros keeping me in favor of the pump.
Have you used a pen for injections? if so, do you find one better than another?
I was on MDI for a year, then the pump. After years and years of it, I took a 3 month break when I was in college. I wa ssick of being tethered to it. I wanted a tan where I didnt have white spots left. I wanted to work out without my infusion site sweating off! I went back to the pump after the 3 months, but the break was nice. I will probably have to go back to MDI soon. I moved to the UK and I have to apply for NHS funding for my pump here. I am almost out of supplies. I wouldnt mind a break again, but overall, my pump offers me the flexibility my lifestyle needs.
We all get sick of it. Dont feel like youre weird! Although, I didnt like the pens much. I got a lot of bruising off of them. I prefer traditional syringes.
thanks, I found your comment very helpful. I have lost several infusion set sites while swimming even after using iv prep to adhere them. also I am tired of choosing clothing to meet my pump needs. but perhaps the break will convince me I really need the pump but I do not feel I will go back to the sensor unless they change the size and ease of use.
I was on MDI before the pump for a few years, before that only NPH. the MDI helped a lot but they had not yet come out with Lantus before I went to the pump so I never really got a chance to use it. If anything the pump has helped me better understand my diabetes and the effect exercise and food has on my blood sugars …so I feel I could slip into MDI easily and try it for awhile and see how it goes. I am just tired of carrying around 2 sets of hardware and dealing with all the work involved in maintaining the sensor and pump… In other words I am burnt out. Seems like a lot of work bu;t not much reward. I have had multiple eye surgerys due to retinal bleed. things are better now but that was a shocker since my A1C was always below 7. that was when my change of attitude began…
Yes, I do reuse the novalog pen tip, but for Lantus I still use a needle and vial and I reuse the needle. Been thinking about going back to the pump since I ran into issues last month with the lantus. The biggest issue was you are committed to that dose for 24 to 36 hours. So if you find you are running low because of it you need to keep eating just so you don’t go too low.
For them getting wet while swimming I used to use a good medical tape you can get at a cvs or walgreens. I used to use NPH and stopped it about 10 years ago when it caused my sugar to drop while driving. I liked the pump because you don’t have to be committed to the basel dose for more then a few hours and can easily change it. I was in a coma last month because all of a sudden I became sensitive to the lantus and went down to 25 while sleeping. Wonderful feeeling when comimg too and there are 5 ems people standing around my bed.
NPH was the insulin from years back. My shots then consisted of one shot of regular and one shot of NPH. It was the long acting insulin. Caused way too many highs and lows. I was dx in 83 and that was the treatment back then.
Thats why most of us here are against Obamacare. We see what goes on over there and in Canada. I have heard some horror stories from both places. What part of the UK are you in?
You stated my feelings exactly right now. I have so many lows on my pump and sometimes feel I had more freedom on MDI, but maybe I just don’t remember correctly. It has been 8 years of pumping for me and often think about taking a pump vacation, but then…I HATE SHOTS, never got use to them in 44 years of this crapola, so in that respect pumping has made my life easier, but it has not stopped me from having a ton of lows with any movement.
I think we have the grass in greener syndrome.
I was not a fan of the MM CGM, I discontinued use of it.
Sorry I have no answers for you, but to perhaps join you in the pump vacation. I see my endo end of May.
Snap I was diagnosed in 83 too. I had to mix shortacting (actrapid) with slowacting (monotard) in a syringe, twice a day. I’ve never heard it called NPH. Was it the cloudy sort you had to roll before drawing up?
It was a very restrictive regime. I remember I had to have my school lunch at 1 o’clock on the dot. Any later and I’d be hypo. I was moved onto MDI (pen for meals and syringe and vial at night) in 87, but still used actrapid and monotard. I don’t think they had the lovely analogue insulins for another decade.
Suffolk, England. We are worried here that we are going to end up with a system like yours. Where we will need to have insurance, and no-one will insure pre-existing conditions. I am lucky that I don’t have to pay for prescriptions, and now that I had another health scare that wasn’t picked up twice, I feel I can push the system a bit. If people desperately want a pump and don’t fit the NHS criteria they can pay for it themselves (much like in the USA). I personally don’t have a £4-5,000 spare a year.
Isn’t it true that some people in the US can’t afford to buy insulin and test strips?
If they can not afford it they have Medicaid here. I kind of like the system here because we have more options. I have heard in Canada that you can only get one type of pump. Here, if the doctor wrights a script for it I can usually get it. Insurance, I was able to get it through my employer and since I had this since I was 11 they did not give me any issues as a pre-existing condition. People who can not afford also have other options available as stated above and some areas have even more options, but they just your finances to see if you qualify for it.
My friend moved back to the US last year, stating all the things you say, absolutely convinced that she would qualify for cover (eventually) despite her brain tumour. And she is now moving back here because it hasn’t proved as easy as she thought.
What happens if you become unemployed? Or are too ill to work? Is there really a safety net?
