My daughter was diagnosed with Type 1 diabetes about 15 months ago.
Although things are going well enough for us, I will not exaggerate and say that life is back to normal.
Rather, it is our new normal.
MULTIPLE DAILY INJECTIONS
She receives four injections a day. Three are fast-acting insulin given at mealtimes to cover the food that she eats and to correct for high blood sugar and the other injection is long-lasting insulin administered at bedtime.
Though her A1C has come down since her last visit to the endocrinologist, it is still above where we should be. And I can’t quite figure out what we are doing that could be tweaked.
The nurse practitioner suggested modifying her afternoon snack to try to bring down her blood glucose level at dinner.
The thing with multiple daily injection therapy is that you have to run a very tight ship. Schedules have to be stringent. Three meals, three snacks all timed so that the fast-acting insulin works as best that it can while her blood glucose levels go up and down in peaks and valleys while the long-lasting insulin works in the background.
Because of meal spacing, her bedtime has been pushed back to 9 pm, which I consider too late for a five-year-old. But dinner beginning at 6:00 with her post-dinner injection about 6:30 means that her bedtime snack and injection can’t occur until 8:30. After which comes teeth brushing and reading.
Another consequence of the injections is loss of spontaneity. Every excursion, every walk around the block, every playdate, every single thing we do has to be planned around meal and snack times. To the tee.
Long gone are the days that we can just decide to take a long walk to the park. Now the kids stand, toes tapping, while I gather all of our supplies and snacks and emergency juice, before we can embark on any adventure.
And when we are at the park or on a long walk having fun, I have to check the clock to make sure that we are back home in time for a scheduled meal.
In some ways it really sucks the fun out of life. The carefree life a five-year-old is supposed to have.
At BlogHer, two different adult Type 1 diabetics (Allison and Kerri) told me that the pump has made all the difference in the world and that I should look into it for my daughter. (I also briefly met another diabetic and noticed that she was wearing a pump.)
The hospital where we are seen is notorious for delaying when a child can begin using an insulin pump. I do believe that we have received excellent care at this top 5 children’s hospital. But I know families who have chosen to go to other hospitals because they will put children on pumps earlier.
Not to mention that our hospital is over three hours away!
Three visits ago we asked about the pump and the nurse said it wasn’t an option yet. Two visits ago we saw the actual endocrinologist and when I mentioned the pump again she said that the deciding factor for her is the amount of Lantus that a child is on (Lantus being the long-acting insulin). At our visit in the past week I again asked the nurse practitioner and she said that we could begin researching the pump.
Though I will say that she didn’t seem too enthusiastic. She said that when we decided which pump we wanted to call and let the nurses know.
I asked what the advantages and disadvantages of both multiple daily injections (which we do now) and the insulin pump are.
She said that basically with the pump there is a risk of DKA (diabetic ketoacidosis) because you can’t be entirely sure that the pump is actually delivering insulin as it should.
I am actually a bit surprised that this is being left up to us to decide and research.
Here are what I see as the pluses and minuses:
-Tied to a strict schedule
-Four or more injections by pen needle and/or syringe per day
-If she wants to eat additional food after receiving her injection, then she must get yet another injection
+ We are comfortable doing injections and with this type of management since it’s all we know
-It will require us learning a new system
-The insertion might be painful
-Our daughter may be scared of something new
-Risk of ketoacidosis
+Flexibility of meals and snacks (she can eat when she’s hungry)
+We can bolus for food as she begins eating and get another bolus if she wants more (currently she gets her injection at the end of mealtime since how much she eats varies so widely; because of this her blood sugar begins to rise before she gets the insulin)
+New insertion set every three days instead of four injections a day
+We are already great about counting carbs (and measuring and weighing)
So here are my questions for diabetics (or parents of diabetic children):
Do you use a pump or get injections and why?
If you use a pump, which one did you choose and why?
Am I delusion thinking that the injections aren’t that hard on my daughter because the majority of the time she doesn’t complain? Or is she just putting on a brave face and has accepted that its her lot in life?
I think at this point I am most interested in the OmniPod since it is an all-in-one unit that inserts itself and does not have to be disconnected during baths and swimming. I also like that there is no tubing for her to get caught on and she won’t have to wear a fanny pack.
That being said, I am sure that the half a dozen pumps on the market all have their merits.