What is important to know before undergoing pump therapy?

What's important to know before undergoing pump therapy? Pump therapy normally is incredibly complex management to deliver. A lot of people don't realise that it needs to be done in an integrated fashion, but essentially mean a lot of people working together. It's not an individual sport. It has to be done in the MDT setting. So when we look at the Pan London service spec, it asks you to work as a group with integrated psychology, because what we don't understand, what most of us underestimate is diabetes distress and also pump fatigue. If you are trying to do things 24 7 with the gastric pump therapy, people do become fatigued, and it's called pump fatigue or CGM fatigue or sensor fatigue. And then we give them pump holidays, which means go away 3-6 months, 3-6 months, don't use pump therapy, do your normal thing like injections, and then come back to pump therapy if you feel that you are distressed, which is too much to do. And also, because it needs to be delivered in an integrated fashion, a lot of psychological issues which are generally associated with type 1 diabetes patients, it needs to be addressed by somebody who is trained in clinical psychology. So if you have to deliver proper fun therapy, it has to be delivered in an integrated model. Because if you try to do it in a non-integrated model, it would be ineffective because the core elements of care are delivered by individual team members separately, and they all need to come together for it to be effective. Even one core element absent, like a psychologist or dietician, can make your all on therapy completely ineffective because they all have their individual positions in it.