If you are keen to pursue insulin pump therapy, or have more questions, here are some next steps you might take:
First, it should be remembered that insulin pump therapy may not be suitable for everyone. You have to be motivated, motivated enough to want to manage your own diabetes! If you have this motivation, then you are a prime candidate for a pump – subject, of course, to you meeting the NICE criteria!
First steps:
Speak with your GP to arrange a referral to a diabetologist if you don”t see a diabetologist regularly now (“Regularly” for people with type 1 diabetes means, to see a diabetologist twice a year).
Optimise your blood glucose control. This may mean taking 4 or more injections a day, 4 or more blood glucose readings a day (and knowing how to act on the results), carbohydrate counting and understanding how to adjust your insulin dose depending on your blood glucose results, carbohydrate intake, exercise, illness etc. You may need to go on a structured education programme such as DAFNE. Insulin pumps have to be prescribed by a pump-trained physician (normally a consultant), so it is important that you have a consultant”s support. Tell your consultant or Diabetes Specialist Nurse that you are interested in getting a pump. You may need to explain why you think it will help, and show that you have considered the drawbacks as well as the benefits. Then one of 3 things will happen:
A. They will support your need for a pump and obtain funding for it. You will be given a start date for insulin pump therapy and any other structured education they think will help.
B. They will support your need for a pump but warn that funding is very difficult to obtain or say that there is a long waiting list. Point out that that NICE Technology Appraisals are NHS Core Standards and therefore mandatory, so the PCT is obliged to provide funding as long as the consultant agrees that you meet the criteria and require a pump. Invite the consultant / DSN to contact INPUT for assistance if they are having trouble with PCTs.
C. They will not support your need for a pump. This may be because they think you do not meet the criteria – do not just accept it, if you think you do meet the criteria; ask questions, be in control of your own healthcare. They may think insulin pump therapy is unnecessary or unsafe – don’t just accept it; ask them what up-to-date research they have to support their view, offer to provide recent clinical evidence that insulin pump therapy is safe and effective (available from INPUT).
If you cannot reach agreement with your current consultant, ask if there is another consultant within the clinic who does support insulin pump therapy and ask to see them instead. If there is no such consultant at your clinic, ask your GP to refer you to another clinic. You have the right to ask for a second opinion. (See Your rights page in the main menu).
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