FAQs

If your question isn’t answered here, send it to input.enquiries (at) gmail.com

So INPUT promotes insulin pump therapy; who else supports it?

INPUT doesn’t promote insulin pump therapy.  We recognise it wouldn’t help everybody, and not everybody would want it – and if they did it would cost the NHS a fortune!  INPUT is raising awareness of insulin pump therapy so that it is available to all who need AND want it.

Diabetes consultants support it – the Association of British Clinical Diabetologists published a position statement on insulin pump therapy in 2006 – link here

The NHS supports insulin pump therapy – and funds it for people who meet certain criteria – link here

Dr Rowan Hillson MBE, National Clinical Director for Diabetes, supports it – article here.

Juvenile Diabetes Research Foundation (JDRF) supports insulin pump therapy – position statement here

Diabetes UK supports insulin pump therapy – position statement here#

My consultant says I need a pump but the PCT will only fund 5 pumps a year and I’m 6th on the waiting list.  What can I do?

Primary Care Trusts are obliged by law to provide funding for however many insulin pumps are needed.  They are not allowed to cap the number of pumps they fund.  They may have set a number so that they can plan a budget but that number is not a cap.  Your consultant may have misunderstood, or the PCT may be putting pressure on the consultant not to prescribe too many pumps.  If your consultant has misunderstood, you can advise him or ask him to contact INPUT.  If it is the latter, INPUT needs to know about it so that we can challenge the PCT and make them aware of their legal obligation.

My DSN says I don’t qualify for funding as my HbA1c is under 8.5%.

You don’t have to meet all the NICE criteria to qualify for funding.  Click on “Latest appraisal of insulin pump therapy” in the menu on the right.  You will see that it clearly states a OR b.  You might want to print off the summary version and show him/her.

My consultant has threatened to take my pump away from me unless I can bring my HbA1c down. What can I do?

Ask your consultant some questions, be assertive but not aggressive.

What kind of improvement did /does the consultant expect? Be aware that under NICE guidance (technology appraisal 151) your consultant is required to review how effective pump therapy is for you, and stop this treatment if it is not effective.  But this doesn’t only mean HbA1c – do point out any improvements you have seen.  Is your day-to-day control steadier?  Have you had fewer hypos that need 3rd party help?  Have you had fewer hospital admissions?  Have you been able to go back to work?

Can they help you make the most of your pump?  What have the consultant and team done to help you bring your HbA1c down?  Have you had extra training sessions?  Have you had regular phone contact with the nurse to discuss your basals/bolus rates and other settings such as the duration of insulin?  It is reasonable for you to expect the consultant and team to help you make a success of the pump before this therapy is withdrawn from you.

How will removing the pump help you achieve better control?  The pump is a tool to help you get the best results.  It is not a reward for good or bad behaviour.  Your consultant’s job is to help you to manage your health in the best way possible.  Ask your consultant how he or she thinks that multiple daily injections will give you better control than the pump.

Don’t be afraid to ask questions of your consultant, and remember if you can’t work well together you can ask to be referred to another clinic.  It’s YOUR health and YOU are the most important member of your healthcare team.

My clinic says I have to do a DAFNE course before they’ll put me on a pump, and there’s a long waiting list.

Under NICE criteria, you don’t have to have done DAFNE or any other formal programme.  However, you do need to have the knowledge that such courses provide.  Some clinics insist on patients being DAFNE-trained before starting pump therapy.  If you already know how to carb count, adjust your insulin according to your results, exercise rules, sickday rules, etc then talk to your clinic about why they want you to use up a valuable DAFNE place when you already have that knowedge.  They might be willing to test your knowledge and let you avoid doing DAFNE.

Bournemouth Diabetes and Endocrine Centre has an online teaching programme that teaches similar things to DAFNE.  Have a look at the website on www.bdec-e-learning.com

I have diabetes as a result of pancreatitis.  Can I still get a pump?

The Diabetes Policy Lead at the Department of Health says:

“As you are aware, patients with pancreatitis are at risk of developing diabetes or, in some cases, a condition equivalent to having Type 1 diabetes.  This is because pancreatitis causes the destruction of the islet cells resulting in the partial or total lack of insulin.  People with pancreatitis are usually given the classification of Type 1 diabetes.

The NICE guidelines on insulin pumps specifically refer to Type 1 diabetes because this is where the bulk of the evidence relating to the benefits of insulin pump therapy sit.  It is important to recognise that the cause of pancreatitis may have an influence on a clinician’s decision as to whether insulin pump therapy is appropriate.

For patients with uncontrolled diabetes as a result of pancreatitis, it may be possible to seek funding through the Primary Care Trust’s Exceptional Circumstances Committee.  However, this is subject to the patient’s consultant agreeing that insulin pump therapy would improve their condition.”

Can animal insulins be used in insulin pumps?

Yes!  See our “Articles and studies” page for an article published in the Journal of Diabetes Nursing in 2011.

Medtronic have addressed some myths and misconceptions about insulin pump therapy here

A lighthearted (but informative) look at FAQs from the Shoot Up or Put Up blog http://www.shootuporputup.co.uk/2009/04/pumping-for-beginners/