A Caregiver’s Journey to Pump Therapy Part 3: Multiple Daily Injections vs. Insulin Pumping
How is the type 1 diabetes journey – from diagnosis, through starting on multiple daily injections, to beginning on an insulin pump and other milestones – viewed and managed from the caregiver perspective? Join D-Mom Leighann Calentine in this 6-part series as she discusses her experiences navigating the diabetes journey as a parent of a child with type 1 diabetes.
When we first began thinking about an insulin pump, my daughter had had diabetes about 15 months. Multiple daily injections (MDI) were our new normal at that point. She was doing fine, but I couldn’t help but think that diabetes management could be easier on her in terms of both the injections themselves and the routine.
While attending a conference, I met three adult women with diabetes. All three had been diagnosed with type 1 diabetes as children. Two of the women, members of the Diabetes Online Community (DOC), I had “met” online and looked forward to meeting in person. The third woman, who I would end up becoming friends with, I met by chance. We were in the same session at the conference and, as she stood up to speak, I noticed her insulin pump. The thing I gained from these women, both in online interactions and now in person, was that my daughter could grow up to have quite normal experiences, like having boyfriends, traveling and going to college…all in spite of having diabetes. What I hadn’t expected was to come away from these conversations pumped to get a pump. For these women, getting an insulin pump really changed their lives with diabetes.
I was now on a quest to learn more about insulin pumping.
Talking with Our Doctor About an Insulin Pump
The endocrinology practice where our daughter was seen was somewhat notorious for delaying when a child could start using an insulin pump. The first time I asked about the pump, I was told “no.” The second time I asked, I was told that they liked a child to be taking a certain amount of long-acting insulin first. My daughter at five was not even close to that dosage. The third time I asked, I was told I could start researching the various types of insulin pumps. My persistence was beginning to pay off.
Weighing the Pros and Cons of Injections vs. Pump Therapy
We began weighing the pros and cons of injection therapy versus pump therapy to decide if we, as a family, and our daughter were ready to consider the switch. We came up with the following list (your list of pros and cons might look different):
- Negative: Tied to a strict schedule.
- Negative: Four or more injections by pen needle and/or syringe per day.
- Negative: If she wanted to eat additional food after receiving her injection, then she must get yet another injection.
- Positive: We were comfortable doing injections and with this type of management since it’s all we knew.
- Negative: It would require us learning a new system.
- Negative: The insertion might be painful.
- Negative: Our daughter may be scared of something new.
- Positive: Flexibility of meals and snacks (she could eat when she’s hungry)
- Positive: We could bolus for food as she began eating and give another bolus if she wanted more (on MDI she got her injection at the end of mealtime because how much she ate varied so widely; because of this her blood sugar began to rise before she got the insulin).
- Positive: New insertion set every three days instead of four injections every day.
- Positive: Overall greater freedom, especially when it comes to activities and sports.
- Positive: We were already great about counting carbs (and measuring and weighing).
- Positive: Lower A1C.
Armed with this list of pros and cons, it was evident that we wanted to move forward, choose an insulin pump from among those on the market and begin insulin pumping. We felt it would be easier for my daughter to join in class celebrations, because the pump would deliver insulin and a nurse wouldn’t have to ready the injection. We felt it would give us more freedom while traveling or going to her grandparents’ house. No more pulling over on the side of the road or waiting for the next rest area so that we could give her an injection. No more filling syringes of long-acting insulin ahead of time so that it could be given by grandma. And we could lower her basal rate during dance classes and sports so that she would be less likely to have a low blood sugar.
Change is difficult, but we were ready to make the change. In the fourth part of this series, I’ll discuss our decision-making process for choosing the right insulin pump for us.
Information posted on Podder Talk is not intended to be taken as medical advice. Always consult with your healthcare provider for questions and guidance on managing any health-related issues.