Why can't I PUMP!?

hi everyone.
I have been diabetic for about 11 months,passed the honeymoon period,and I am a bookworm who reads everything so I pretty much know everything about the pump.
my story starts long ago,I have been insisting on a pump since day one,but their was always something wrong with me,too high,too low,bad fasting BGs,I wanted the pump so badly to the point I was doing count downs for the next appt. ,which I would be telling the endo about the pump,and which the endo would refuse.
but one day she agreed and put me on a CGM to see if it was suitable for me to pump.
that week was a special one,I felt that I was under observation,I have been so strict!and it was hard to be so straight,I have no time for correcting a 150,but I did,testing all the time,my numbers were all between 100 and 200,I was so proud of my work and believed I would get what I deserved.
then,2 other endos came,the regular one and the other agreed on the pump and liked my numbers,but the older,expert one said no!
he talked about my hypoglycemia unawareness and how I wouldn’t wake up if I got a low during the night,as the pump keeps pumping.
I worked so hard for it,that’s why I am kind of rebelling right now,I feel like giving up,I can’t believe that I have to start allover again!
the question is;how to convince them?that I am capable of pumping and all,I won’t change the endo for many reasons,so if there was any other way you know,please help :frowning: !

Probably a stupid question, but have you explored with your endo the option of using a CGM full time to help with your hypoglycemic unawareness while on the pump?
I don’t see why that wouldn’t be a viable option. Besides the answer to hypo unawareness shouldn’t be restricting the patient from methods that could offer better control.

Since pumping , including poking fingers more often !!! , and it did not happen overnight , I have become much more aware of low blood sugars . As a matter of fact, my Endo suggested a pump ( back in 2000) because the records showed , I was hypoglycemic unaware . .
I think one of the criterias to start pumping should be : how many times a day are you willing to check your BG ( I was asked , when I met the pump Nurse the first time …6 times within 24 hours is not enough in my mind .Hope this is helpful for you

Sorry for the frustration! Don’t feel defeated.

Well, taking basal at night there would be a greater chance of hypos than with a pump (if you are taking evening basal shots), so that’s not an answer.

I’d ask the endo what you have to do to qualify for a pump. Have him tell you specifically what you need to achieve so you can meet those goals. If it’s hypo unawareness, then he should instruct how to control this better by not letting BG drop dramatically either by redjusting your ratios, timing of insulin, or running a bit higher to re-set your awareness.

Docs are understandably concerned about overnight lows, but denying you a pump isn’t the solution.

I would keep at them,get your carb counting under control and show them you mean business.
Show them the pump will improve your life and most importantly dont give up.

One of the reasons I got my pump was because I have hypo unawareness, also dawn phenomenon. The pump keeps pumping at night but you adjust your basal rates hourly to stop you having lows. I have to increase mine from 4.00am to 7.00 so I don’t get highs. I have only had my pump 7 weeks and I wake up now with perfect BG, in the 70’s instead of before 300 maybe. So I definitely think you would be a candidate for a pump. Hope you have better luck next visit.

that’s weird b/c my endo wrote the prescription for my pump b/c b4 i struggled with going hypo from my lantus

The logic from the endo is all wrong and out of date. That endo would probably except an A1c of 7.5 as tight. Go the the ADA (diabetes.org) and look for the new diabetes diagnosis and treatment guidelines and see if you ca get some ammo there. Stand your ground on the pump because it is farm more flexible in so many ways so that you can avoid the hypos and if you are having hypo issues you can make adjustments that will take effect in two hours. Withe MDI and lantus you sill have to wait at least 24 hours (good one for the old Doc to hear).

Depending on the pump company, you may be able to get a 60 day return when you try it out, and during that time you can show’em!

The CGM is the best tool out there with out having to strip test every five minutes, which is the function of the CGM. You can also produce numbers to justify the pump in the long run…and what a run it is Doc!

I’ll be rooting for you.

Saya, I am so sorry for your frustration and how they are making you wait. I would echo what others have said here…ask the docs specifically why they think you do not qualify for a pump/CGMS and ask them what would convince them that you do. Then go about proving that and don’t take no for an answer…sometimes, easier said than done. I think frequent testing will show where your BG issues are and that you are willing to test/follow up a lot. Getting your night time blood sugar records documented will likely be most compelling given a pump allows you to fine tune these rates and prevent hypo and hyperglycemia at these times…no MDI regimen can really do this. Good luck and keep us posted on your progress…hang in there:)

I know,I thought of that,never told him,bacause he probably,maybe,have already thought of it :slight_smile:
yeah,that’s what I think.

I poked myself around 12 times those days,I wouldn’t mind,it would be easier than doing this :slight_smile:
the nurse in my school used to be an educator in the same hospital I go to,she told a secret,she said the key was to call them everyday to tell the readings :slight_smile:
thanks nel :slight_smile:

yeah,ask him straight out would be a great thing to do,I alays tell my self to do so but never did :smiley:
I just don’t get it,he’s like,no,you controled it for one week,why not do the same!?

the regular endo knows that I am serious when I say I want a pump,she was all like:she’s cooprative,she’s good and all,but no,I am meant to be in this position I think! :slight_smile:
thanks Osob :slight_smile:

I told that to everyone I know,so does the lantus!
that’s exactly my thought! thanks Arielle! so afterall I am not the only one!

your story is like a fairy tail. but there are no princesses nor crowns.
a diabetic fairy tail is all about CGMs,insulin pumps,and stem cells maybe!
thanks Danny :slight_smile:

that’s what I am gonna say next appt.
I am gonna be like,ready and everything,as if it was a debate :)thanks Collete for your kind words,they kind of lighten the burden on my back =D

that’s what I hear all the time,even the his center’s booklet says so!

thanks Woodward,I well take your advice.
especially the part where I have to stay on my ground,I know how flxible it is,so I am pretty hopeful :slight_smile:

ask the docs specifically
this is the best one that I am definitely following :slight_smile:
thanks for your advices all of you,they are really helpful,my appt, is like,1 month far,so good luck bearing your curiosity ! :smiley:

Saya, my endo always gives me a written summary of our appointment discussion. It would be great if you could get the same thing from your endo, so you have the “qualifications” in writing. Once you have it in writing you will be able to keep them to their word. I know you said you won’t change endos but given the fustration your group is putting you thru to get a pump I would suggest you consider the possibility. If you are a legitimately good pump candidate and they are standing in your way for no good reason other than physician stupidity then you will never get your pump or the proper type of support you need while you are there.

As far as going hypo overnight and the pump keeps pumping, please tell your docs that many pumps have a feature where if you don’t push any button within a given amount of time (say 12 hours) the pump will shut itself down. Hypo unawareness is no reason to deny someone a pump and as you’ve seen, many people have gotten pumps for that very reason.

I wish you the best of luck on this!