Insulin pumps are being used increasingly in diabetes, and a comment made by someone with diabetes before they started using one got us thinking. They said that they had undergone so many discussions to make sure that they were suitable for a pump, that they were scared of what might happen if it didn't work for them. They felt pressured to make it work, and also got the feeling that they had a one-off chance of trying a pump, so if using it didn't go well they would never get the chance again.
Hearing this reminded us that insulin pumps are still not seen, in most diabetes teams at least, as a standard choice for the treatment of Type 1 diabetes. Despite the clarity of NICE guidance (NICE, 2008), people still have to undergo relatively rigorous assessments from their diabetes health professionals, and also insulin pumps are used in many cases as a 'last resort' rather than just one of the potential insulin delivery methods to choose from.
Why is this? Well, insulin pumps are regarded by many diabetes teams as an expensive luxury that should be reserved for a select few people with diabetes. However, expensive relative to what? Many long-term conditions have far more expensive investigations and treatments, including sophisticated scans and surgical procedures, and by comparison the 'routine' treatment for diabetes to keep people healthy and prevent complications is relatively cheap even when insulin pumps are included. They also have the added advantage of taking away the sheer tedium and public nature of insulin injections, two aspects that have such an impact on how people cope with having type 1 diabetes. In these cash-strapped NHS times, there is a danger of diabetes health professionals succumbing to the pressure to use the cheapest treatments rather than those that people might prefer long term if given a real choice.
So come on, the world of diabetes in 2012. Let's start putting insulin pumps in their right place - as a real choice for the majority of people with Type 1 diabetes, in common use in every diabetes team, with all health professionals trained and competent to use them.
To pump or not to pump? Let us know your thoughts…..
Reference
NICE (2008) Diabetes - Insulin pump therapy (TA151)
http://www.nice.org.uk/nicemedia/live/12014/41300/41300.pdf
I'd second that. Insulin pumps won't be great for everyone - nothing is - but they should be on the list of treatments to be considered, and certainly not as a last resort or a special case as seems to be the case in some areas at the moment.
ReplyDeleteI've had a pump for 5 years and wouldn't give it back for the world. I didn't feel pressured to make it work - but I wanted it to work. And I made sure I did as much reading and preparation as possible so I understood it and could make best use of it.
Thanks Alison, it's great to hear it's been so successful for you. Do you have any tips for anyone who'd like a pump, but can't get access to one?
DeleteDo your research. Make sure you're clear in your own mind about how a pump could benefit you (they aren't a magic cure all, they're just a clever bit of tech) and then try to convince your team of that. If your team are unsupportive of pumps - consider moving to one that is. If they're supportive but the PCT won't agree funding, write to the PCT and speak to campaign groups like INPUT for tips on how to lobby them effectively. My experience was that if I wanted it, I needed to lead the fight for it and I needed to know my facts to do that. You can see more of my pump tips here http://www.shootuporputup.co.uk/resources/about-diabetes/pumps-faqs/
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