Stuboy
03-09-2007, 11:02 AM
I thought this might be an interesting read for anyone thinking about, or confused about the criteria for getting an insulin pump in the UK.
Who should have access to a pump service?
As a reflection of NICE guidance on pumps and management of Type 1 diabetes, CSII should be considered in adults after a trial of multiple dose insulin therapy (MDI), including use of long-acting analogues, and a course of structured education. It is of particular benefit for:
Those able to achieve target HbA1c (<7.5% without complications, <6.5% with complications) but only at the expense of frequent hypoglycaemia which has an adverse effect on quality of life
Those who have made significant efforts to optimize control but have a high HbA1c due to marked fluctuation in blood glucose levels and for whom further reduction in levels will result in unacceptable hypoglycaemia
However, it is important to consider all of the critical elements of care, not just failure of MDI which was the “gold standard” of intensive diabetes care in 2003, but has now been updated by more recent guidance15. Insulin management is difficult, as individuals need to manage their diabetes in the context of lifestyle, danger of hypoglycaemic
events, and so on. To provide the individual with maximum support, all individuals should have the opportunity to take part in structured education on an ongoing basis16. This education should meet national guidelines, and be provided at times appropriate to the patient’s needs. Ongoing insulin management should normally be reviewed as part of the care planning process17. Particular attention also needs to be given to glycaemic control for those who are pregnant, or planning a pregnancy, and those with accelerated complications.
http://www.diabetes.org.uk/Documents/Reports/InsulinPumpServices.pdf
Who should have access to a pump service?
As a reflection of NICE guidance on pumps and management of Type 1 diabetes, CSII should be considered in adults after a trial of multiple dose insulin therapy (MDI), including use of long-acting analogues, and a course of structured education. It is of particular benefit for:
Those able to achieve target HbA1c (<7.5% without complications, <6.5% with complications) but only at the expense of frequent hypoglycaemia which has an adverse effect on quality of life
Those who have made significant efforts to optimize control but have a high HbA1c due to marked fluctuation in blood glucose levels and for whom further reduction in levels will result in unacceptable hypoglycaemia
However, it is important to consider all of the critical elements of care, not just failure of MDI which was the “gold standard” of intensive diabetes care in 2003, but has now been updated by more recent guidance15. Insulin management is difficult, as individuals need to manage their diabetes in the context of lifestyle, danger of hypoglycaemic
events, and so on. To provide the individual with maximum support, all individuals should have the opportunity to take part in structured education on an ongoing basis16. This education should meet national guidelines, and be provided at times appropriate to the patient’s needs. Ongoing insulin management should normally be reviewed as part of the care planning process17. Particular attention also needs to be given to glycaemic control for those who are pregnant, or planning a pregnancy, and those with accelerated complications.
http://www.diabetes.org.uk/Documents/Reports/InsulinPumpServices.pdf