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Re: [IPk] Pump Funding

Dear Suzanne

Re the higher target: remeber the NICE criteria for pump funding!
"Continuous subcutaneous insulin infusion (CSII or insulin pump) therapy
is recommended as a treatment option for adults and children 12 years and
older with type 1 diabetes mellitus provided that:

   - attempts to achieve target haemoglobin A1c (HbA1c) levels with
   multiple daily injections (MDIs) result in the person experiencing
   disabling hypoglycaemia. For the purpose of this guidance, disabling
   hypoglycaemia is defined as the repeated and unpredictable occurrence of
   hypoglycaemia that results in persistent anxiety about recurrence and is
   associated with a significant adverse effect on quality of life


   - HbA1c levels have remained high (that is, at 8.5% or above) on MDI
   therapy (including, if appropriate, the use of long-acting insulin
   analogues) despite a high level of care."

If you need a higher target number because of hypos, you probably meet the
hypoglycaemia criterion right now.

All best


On Sun, Jan 19, 2014 at 1:17 PM, Suzanne Allen <
email @ redacted> wrote:

> Hi,
> Thank you for your comments about my pump funding problem.
> Melissa: thanks for that useful point.  I have an appointment with the
> consultant in May.  I need to agree another target a bit higher than 7.3
> with her as I have been experiencing a lot of hypos to get it.  Also, for
> the last 6 weeks I have been doing two hourly blood tests through the
> night,
> every night, to try to get the overnight basal doses right.  The situation
> is therefore untenable in the long run and I need to agree a more realistic
> target with her.  I will then ask her to put that in writing to me.
> Di: You asked why I had postponed the holiday.  The reason is that I always
> struggle to have good control when I'm on holiday.  I'm used to weighing
> everything at home, which I can't do on holiday and I'm not very good at
> guesstimating carb amounts even with the help of the "Carbs & Cals" app on
> my phone. Also had problems with the app showing portion sizes at times.
> With the holiday we are hoping to do, we'll be on the move quite a lot so I
> won't even have the benefit of being in one place for long enough to start
> working out the carbs from that hotel's portions.  I didn't want three
> weeks
> of possibly out of target results to have a negative impact on my HbA1C
> result.  I have to say though, that that I have a few more tools to fire
> fight with now, so may have slightly better control this time.
> Regards,
> Suzanne
> .
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