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[IPk] NICE one

>The difficult area would be for those people who switched to a pump
>personal choice but previously had HBA1c's of less than 7.5 when they
>on MDI.
>Again, if they got their under 7.5s with glargine, but had 'disabling
>hypos', however that gets defined eventually, they are fine.  If this
>was with another basal insulin, even if they had a string of ambulance
>admitals, they could be forced to go and try glargine.

I switched to a pump through personal choice a year ago i.e. I am 
self-funded and had to plead for authorisation.

My pre-pump HBa1C's were 7-7.5%, despite terrible day-to-day control on MDI 
and they are currently at 8.5 - they have gone up since being on the pump.  
However, my day-to-day control has improved greatly. So I fit into the 
Steve's 'tricky' category above.....

However...... my new Diabetes team at Bristol Royal Infirmary have 20 pump 
patients, ALL of whom are self funding (according to the nurse....).  During 
my check-up appointment today she informed me that self-funding pump users 
will not be forced to revisit MDI using Lantus.

Well money clearly talks (I am paying for my own treatment, HBa1C's 
acceptable, let him do whatever he likes with his pump....)


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