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[IPk] RE: NCE Guidance



Hi Joel


>From what you say in your email you definitely meet the criteria for a pump due
to the unpredictable hypos whether on the new or current guidance.

I think that you have stated your case very clearly in the email.    Have you
written all this down so that your consultant has this info in front of him?
This is what we did for my daughter. We gave copies to the GP and DSN and
consultant.


I hardly think that testing 6 times a day is excessive given that these blood
 tests results are only information one has available to make adjustments to
your
insulin and diabetes management.  In your case as you have poor hypo awareness
then of course you need to test frequently.  There are about 55 parents on the
UK CWD mailing support group and most of the parents test over 6 times a day.

I am not sure why the link on the NICE guidance is not working.

Here is the direct link to the PDF of the lasted appraisal determination which
is still on going.

http://www.nice.org.uk/nicemedia/pdf/FinalAppraisalDeterminationIP.pdf


Jackie


>
> Hi Jackie:
>
>
>
> When I click on the link I get into the NICE site but I still get a
> "Guidance Error" message.
>
>
>
> Thanks for wishing me luck. I put together a "Case for Support" which I gave
> to the pump nurse who carried out the initial assessment last week. She
> feels that I would be suitable for a pump and we are now moving to a full
> meeting with the consultant, the pump nurse and the dietician, next week.
> My case included details from the past 3 month's meter data (10-12 tests per
> day) which I download to my laptop.
>
>
>
> I am applying on the basis of "Excessive and Unpredictable Hypoglycaemia".
> My last two A1c was 6.3, although the large number of low readings are
> probably driving it down.   It has been hard to find out what typical hypo
> frequencies are for other T1's, but my meter logs for the past 90 days show
> 135 episodes of 3.5 or below of which 62 were 2.9 or lower. Despite
> assiduous attempts to cut my Lantus to an absolute minimum, I have frequent,
> rapid (sometimes > 3 mmol per hour) drops in BG  at times when I have no
> bolus insulin on-board.  These are usually during the day, although recently
> more have started to occur  overnight. This is affecting my work (try
> lecturing to 300 students with a BG of 2.7)  and means that at risky times
> of the day (e.g. late afternoon) I am not safe to drive.  On some days, I
> have had 3 separate hypos, and I find this is not only stressful  but is
> starting to affect my mood.
>
>
>
> At our meeting the pump nurse suggested that I was testing too frequently
> and wanted me to cut back to ~ 6 per day to avoid "obsessive testing".
> However, since my hypo awareness is now pretty poor (I can go as low as the
> mid to low 2's without any warnings) I actually feel more anxious if I do
> this, since I have no warning that my BG may be dropping.
>
>
>
> Any help with my "Case for Support" would be greatly appreciated. I could
> send it to you directly as an email attachment.
>
>
>
> Thanks
>
>
>
> Joel
> .

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