Many of our patients who have been on insulin pump therapy wish to take a "break." Some do so because of the summer in which they take off their pump for extended periods of time; some because their bodies need a "rest" from the infusion sets and some - just because.... We, as a team, never insist that our kids stay (or go back) on the pump if they do not wish to. Often, I only find out when the teen (or child) is "acting out" or not performing the necessary diabetes pump related tasks that they are doing so subconsciously in order for me to remove the pump! Usually, this revelation is at the cost of much emotional turmoil and tears... and relief.
I often suggest "pump vacations" to my patients over the summer, during athletic competitions (if they are anxious the pump can be managed well with appropriate assistance for all sports), and if, for whatever reason, they need a break. If we insist that a child or teen stay on the pump without his full endorsement, we will not be acting in his best interests and pump therapy will not be successful. At Children's National our Diabetes Program Coordinator, a nurse and clinical diabetes educator with type 1 diabetes, employs pump therapy during the weekdays when she works with families and multiple injections with basal insulin on the weekends. She feels that her skin sites are given a rest and she has all her diabetes related stuff easily available at home. It works for her!
In summary, it is difficult enough to "act like a pancreas" with either insulin pump therapy or multiple daily injections. Why make it even more stressful to worry about which regime is "right?" It is most important to determine which insulin therapy is right for you at any given time; keeping in mind that circumstances change and that you can change insulin regimes at your will.
Coming up soon: How do you combine insulin pump therapy and multiple daily injections?
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