Starting a Child on an Insulin Pump

Mary Kate Cary Health Guide
  • As most of you know, my daughter’s numbers have been high lately (we’ve had three HbA1C tests in a row that were 8-plus). As a family, we’ve switched to a low-glycemic index diet – I’ll save that for another blog – and are considering moving to an insulin pump from our current Novolog and Lantus regimen. Research shows that kids who wear a pump have consistently better blood glucose levels and A1C numbers. Unfortunately, we don’t know too many kids with pumps – Annie is the only kid in her lower school with diabetes, and the one younger boy we knew who had a pump just moved away. She doesn’t know any girls her age with one.
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    The problem is that the same reason that my eleven-year-old daughter’s numbers are high – the onset of puberty – is the same reason she is refusing to wear a pump. “I don’t want anything attached to my body,” she says, in that way only a pre-teen girl can. “I don’t want people to see it,” she adds, and “What if it hurts?” On one hand, I don’t want to push it and have things back-fire on me. I’ve got to respect her feelings about her changing body, her not wanting to be different from other girls, her fears and her new self-consciousness. If I’m too autocratic, she’ll dig in her heels. On the other hand, we’ve got to get her numbers down and at some point we’re going to have to force the issue to prevent her getting devastating complications down the line. So her veto is not absolute.

    (By the way, she has no idea of the complications – yet. My husband and I have chosen not to tell her about all the bad things that can happen. We will someday, but not until she’s older.)

    Then I had an idea: why not wear a pump myself, to show her how it would be? I called Medtronic and asked if I could wear an insulin pump – the one that is linked to those new continuous-read glucose monitors. It would be filled with saline instead of insulin. They said yes, but only to a pump. The problem is that the continuous-read glucose monitors are not approved for children, and even though I am an adult, it is my daughter who has diabetes and they cannot look like they are marketing toward children. So I got just the pump to wear for three days.

    For those of you whose kids have a pump, this is nothing new to you -- in fact, you may have worn a pump yourself before they got theirs. But for those of you who haven’t done so, I’d highly recommend it. Here’s why:

    • It didn’t hurt AT ALL. I thought inserting the tubing would feel the same as getting my finger pricked – which, by the way, hurts! – so I was ready to flinch and then say it wasn’t all that bad. But before I could put my “game face” on, the thing was in and I never felt it at all. No kidding.

    • We programmed it with my daughter’s carb/insulin ratios and correction factors, so that all her information was in it instead of mine. This allowed us to use the Bolus Wizard for three days and calculate her doses much more easily than the manual calculations we do now.

    • When she was high, the pump would beep every two hours to remind us to check her again and give her another correction until her numbers came back into normal range. Great because she was high all week and this helped.

    • She, however, noticed that this meant more shots for her and only a few buttons pushed for me to get more saline. The pump significantly reduced the hassle factor of having to prepare more shots. Plus you don’t actually have to get the shot, obviously.

    • There are accessories you can buy to hide your pump (little covers, even little socks so you can slip it down your bra) but for the short time I had it, I attached it to my pants waistband like a pager. Of course every time we ran into a friend, they’d see it and ask about it. I’d show them the pump, explain that it was the latest technology and that lots of kids who have diabetes have these. I didn’t try to hide it or be embarrassed by it. Just part of life. I wanted my daughter to see that aspect of it, and that it doesn’t have to be a big deal.

    • When it came time to take it off – I had run out of saline and the three days were up – we did it together so we could see if it hurt. As we were pulling off the sticky patch that holds the infusion set on, it felt the same as pulling off a really sticky band-aid. I was so focused on the band-aid feeling that I didn’t feel the tiny tube come out! No bleeding, no nothing. The whole thing really was painless.

  • Earlier this summer, when we talked about getting a pump, Annie’s response was “No way, no how.” But I noticed when the pump trainer came to show us how it worked and put it on me, Annie asked almost as many questions as I did. We asked if people switch back and forth between pumps and shots, so she’d have an out if she really didn’t like it. Then, once I was wearing it, she’d ask things like, “If I was wearing a pump, could I go on more sleepovers?” “If I was wearing a pump, would you still have to chaperone the overnight choir trip at school?” “If I was wearing a pump, would I still have to find my teacher at lunchtime to oversee my dose?” She’s starting to realize that not only does the pump represent less hassle, but also more freedom. Not a bad thing for a pre-teen girl who is sick of having diabetes.
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    I’ll keep you posted on our progress. As my husband said, “We’ve led the horse to water, now we just have to see if she takes a drink...”
Published On: September 11, 2006