Diabetic Concerns About Starting an Insulin Pump

Kim Benjet Health Guide
  • We looked into insulin pumps within months of our son’s diagnosis, but it took us two years to start pumping.  The delay was of our own choosing and because of our own fears, but honestly once Josh started pumping we wished we had started sooner. Here are some of the fears our family confronted and the truth of the experience.


    DKA:  I was terrified that the pump would just stop working and Josh would go DKA before we even knew it was happening.  In reality, we test blood sugars at least every 4 hours when Josh is awake so we catch rising blood sugars.  We use a blood ketone meter to check for ketones when he is high so we can treat early if there are ketones. At night we check at 11 p.m. when we go to bed, and if he is high we give an injection so there is correction insulin on board.  He may still wake up high but at least there would be 3-4 hours of rapid acting insulin working.  We used to wake up at 3 a.m. to make sure his blood sugar had gone down but I have to admit we don’t always do that.  We’re a family that likes our sleep.  In two years we’ve had one morning when Josh woke up with a stomach ache, vomiting and ketones due to a pump or insulin problem and they were gone within 3 hours of treatment.

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    Psychological Impact:  Were we pushing our child into a treatment he didn’t want?  Okay he doesn’t want diabetes, he doesn’t want shots.  We see the pump as just a tool to help us deal with the diabetes.  Some people may think it’s too burdensome for a child. Others think the child must be able to manage the treatment themselves (we left one medical practice that had that philosophy). Children can’t handle multiple daily injections (MDI) themselves so why would we ever assume they would handle the pump themselves?  I actually think MDI is more challenging than pumping.


    Would wearing a pump make him look sick?  My bias was that sick people were attached to machines.  I hated seeing the tubing because it seemed like a constant reminder that Josh had diabetes.  But after a few months of pumping, the pump gave Josh and our family more flexibility and freedom.  He was not straitjacketed into prescribed eating times or meal plans. And we could deal with the intermitent exercise a child has throughout the day.


    The Infusion sites:  When I tried it on myself I was so tense and was then pleasantly surprised to find it did not hurt as much as I expected. Josh too was tense in the beginning.  So we practiced site injections into a pillow and sped up our infusion techniques to lessen the anxiety about the site change. Some people use emla cream to numb the site before insertion. We found that using the cream makes the process longer so it doesn’t work for us.  However, when Josh is just sick of site changes we may use the emla cream just to “change things up” and subtract the insertion pain from the equation.


    Site scarring:  I was afraid my son would start to look like a pin cushion. Sometimes sites do take longer to heal.  If the site is at all red we are quick to use an antibiotic cream to fight any infection.  We also found that sites tend to heal slower in the winter.  Dry skin inhibits healing so now we use a rich lotion like Nivea or Aquaphor to treat the dryness.


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    Adjusting basel rates:  I have to admit that this was the one area I had the hardest time making sense of but it’s now one of our most effective tools.  After the careful calculation by our health provider and then the basel testing I thought we had perfection and was extremely reluctant to change a basel rate. Instead we’d just correct high blood sugars. But constant correcting actually resulted in more insulin use and often that awful up/down feeling for Josh.  It’s much more effective to be proactive and change the basel rates instead of giving too many corrections.


    So in conclusion, I would recommend trying the pump.  Keep your expectations in check. It’s not a cure. It’s labor intensive in the beginning.  We still have out of range numbers, high and low blood sugars. It’s not perfection. But, for my child and our family it’s the best tool on the market for managing diabetes.

Published On: April 17, 2007