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Subject: [IP] Re: pump-for-sale issues

Title: Subject: [IP] Re: pump-for-sale issues

Not all new pumper's unattached to a team is buying pump's illegally. I have been going to an
Internist for years and handling my numbers with him and on my own. My Hb1ac's were in the low
6's (6.2 b4 I started pumping). I choose to go on the pump myself and contacted Minimed. They
contacted my internist, and handled all the insurance aspect's (covered 100%) over the phone.
The Minimed Pump trainer met with my Internist and trained him (although he's still clueless on
the pump) prior to me getting hooked up. I wanted to go on Insulin right away. When I was
scheduled to be attached, the Minimed Pump trainer advised me to learn the manual front to
back and watch the video several times. If she felt I wasn't ready, she would attach me with saline
and come back a second time. I studied the manual, watched the video constantly, and read Pumping
Insulin by John Walsh. She stated within the first few minutes after meeting me, I was definitely ready.
She called again later that day to check on me. The Carb ratio's and ISF ratio she figured out for me was
right on the money. Although I was supposed to call my Internist during that time, I never did, nor did he
contact me. I was very lucky nothing happened to me. I also was very intensive checking my BG's, and being
conservative changing carb ratio's and Basal pattern's. I then went to secure a Diabetic team to help fine tune
me, and found a few of them prejudiced that I had put myself on the pump, and even talked negatively about
Minimed allowing me to do so. A CDE I had a bad experience with, could not get past this. She ranted constantly
about Minimed setting people up on the pump, then they have to pick up the pieces to control them. I was in good
control before I decided to get they're help. Proof of this was my recent Hb1ac of 5.3. I also found out if I
wanted to go on the pump, and went to a new Diabetic Team, I would have had to wait at least a year before
being approved by the team. I realize the pump isn't for alot of people. You need to take a more intensive approach
to controlling BG's, if you haven't before, but I was doing so. Prior to going on the pump I went to a nutritionist and

started carb counting. I received a diet that I was going to start once on the pump. I started the diet a month and a half

early using MDI. I think some Endo's & CDE's are too stringent in they're thinking towards putting patients on pumps.
It's basically an alternative delivery system to injections. The benefits are better control once you learn the process.

What would they do if federal guidelines mandate that the better treatment method for controlling diabetes is with the pump? If a patient is non-compliant on injections, then they would not be a candidate for the pump. Too many things could happen

with no background insulin to cover, or a constant dosage administered to someone who doesn't know where they're BG is.
But if a patient was intensive about controlling BG's, was even on MDI, then they shouldn't need approval from they're team.

We need to get more people on this, not make it a select club for overachievers. As it is most undiabetics, even in the medical

field do not know what it is by looking at it. There isn't enough press coverage done to educate the population on this. My

five year old daughter was Dx'd 12/99, and was 2 injections a day. She is pumping as of this month because 1- her team did

not have a child that young on the pump and wanted to wait a year after Dx'd, 2 - My wife and I heard of an eight year old

that went on it and was made fun of by her classmates. She was made fun of because of the lack of information the public has

on this small group of diabetics. Maybe if more diabetic teams offered the pump as an option, and there were more of us
the public would be desensitized by it, and wouldn't be prejudiced of it. It's pretty sad when we delayed putting my daughter

on a better method of treatment because we were worried about her socialization with her peers, and being made fun of.
This shouldn't be a closed society to the fortunate.

Date: Thu, 27 Jul 2000 14:56:55 -0700
From: "Keith Johnson" <email @ redacted>

The CDEs at the diabetes center I frequent tell me they've been getting folks
walking in off the street with pumps in hand, wanting the CDE team to help them
set everything up. Not a good idea, of course, but now I wonder how they got
them in the first place. Do the companies supply the devices without prescriptions?
Or do they supply the prescriptions as well? Either one seems a bit over the
line. I suppose it's more likely some nameless doctor wrote the
prescription, but wasn't able/willing to give more help.

Anyway, the team is considering doing a study of pumpers they've helped get
started, to find out how successful they were, and how that correlated with
their attitudes toward diabetes and pump management. They hope to set up
more effective criteria for deciding who should go on the pump. I know, it
should be available for anyone, but you and I _know_ there are some folks
who just shouldn't even start. My center generally insists they take their
advanced diabetes management class (an excellent one-week workshop), or the
equivalent, before they start a pump.

Keith Johnson