Does anyone still do shots? What is the major advantage of a pump

General
1

Hi.  My son Alex was diagnosed in August 2008.  he was put on Lantus & Humalog shots.  He takes 6 shots a day ( more if his BS are high).  He is going to camp this week and most all the kids are on pumps.  He had a boy at his school last year who also had a pump.  He talks about wanting to get one but they really scare me.  What if the cord comes loose, bubble in the tube, lose the programer... I am very uninformed about the pumps so I need to go to a class and learn more about them.  My doctor brought up a CGM at our last visit.  That attach's like a pump correct?

Just wondering if I am the only parent that still uses shots ?

2

I've been T1 for 16years, except for a brief 3month trial of the pump in Oct-Dec 2009, I have been on shots all my life.

The pump was more inconvenient for me, and caused my control to become worse, than shots so my endo and I decided I should switch back. There can be some advantages to the pump, but like with using shots, it's all personal preference. It might work for the kids at his camp, but it might not work for him. It's a LOT more expensive and it is more work(in my mind after having one for three months) than shots because you have to worry about things like failed sites, etc. I personally went through a month supply of infusion sites in 2weeks because they kept ripping out while I was sleeping or catching on things or failing. I cried almost daily during the 3months I was on the pump due to stress from having it not be this "magical machine that would make everything better" like so many people say..and I'm not one to cry often at all.

The pump itself was fine, I had the Animas Ping, it was more having ti attached 24/7, having to worry about sites, where to put it, and my bloodsugars having no pattern so we couldn't pin-point a basal rate even hourly that would work more than one day before needing to be changed again.. etc etc that I had the problem with it.

I think if you went to an information session it would help you make a decision, in the end if you aren't sure..there's always the option of doing a saline trial to see how he handles the pump being attached and then moving onto a 3month insulin trial like I did.

My mom was really excited when I wanted to try the pump, after years of her and my endo asking if I wanted to and me flat out going "NO!" because like you, it freaked me out(those brochures with kids playing soccer with them on, the idea of them getting ripped out make me wanna throw up..and then when i experienced a site getting ripped out when i was running...it validated my fear haha) but after seeing me on insulin for just one week, she changed her mind. I was determined to give it the 3months at least before deciding..but she saw everything i went through(because i lived at home at the time so i could adjust to the pump without worrying about rent) and hated every moment of it. she doesn't hate the pump, thinks it's great for some people, but doesnt want to see me on it again until i am wanting to have a family and the technology has improved(same thing my endo said when i told him i wanted off, he agreed with me on going back to shots because the pump was failing so bad for me)

 

A CGM is similar to the pump if only because you need to keep a small computer on your persons at all times and there's also an infusion site type needle that stays in the body. CGM's are wireless though, so there is no tubing to worry about. From what I understand, you still need to worry about hitting nerves or getting a bad spot, but it's not as damaging as having a pump site fail.

I am actually going to my endo today to discuss getting a CGM to help me gain better control. Sadly, in Canada the only CGM option is the MM Guardian, though I'd much rather get a Dexcom.

 

3

The pump has three major advantages in my view: 1) once you set up your rates, you no longer have to "guess" how much insulin to give yourself for each food intake - the pump is set up to deliver a specific amount of insulin based on your set rate and your current blood sugar;  2) because of the aforementioned reason, many people see an improvement in their A1C results; 3) you don't have to bare part of yourself in public or go to the bathroom to get your meal injections when out in public - just enter your carbs into the pump discreetly and the insulin gets delivered on the spot.

I'll admit I hated the pump when I first tried it back in 2003.  I forget which version I had, but there was a real problem in giving myself showers (the infusion set adhesive would fall off rather easily from my abdomen when water hit it) and in keeping the pump on while I slept (part of the reason for the latter problem is I wasn't really aware that it's easier to just set your pump off to the side on the bed while still keeping it attached to your abdomen - I kept trying to sleep with it still hooked onto my pants!). 

However, the infusion set adhesives for the Minimed Medtronic Paradigm 722 (the pump version I currently have) stick to your skin far better than the ones I used back in 2003.  I've also learned better sleep habits and have only had my infusion set come off twice in a year and a half when my tube got a little too far from my body and a fast motion I made aided in its dislodging.

The only thing that still irritates me about the pump is how the infusion set frequently gets caught in the quick insertion plunger device when I'm trying to put on a new set (infusion set sites need to be changed every 2-3 days for pump users).  When it gets caught in the plunger, there's a high probability the needle won't jab through your skin fully, and/or the circular adhesive won't attach completely to your skin because part of it is still caught halfway or so in the plunger.  The only solution to this that I've found is to cut along the circle of the adhesive so that it becomes smaller and doesn't catch in the plunger upon the next insertion attempt, but when the adhesive is cut into a smaller circle, there's a higher risk of it accidentally dislodging from force (one of the two times the set came off me at night is when I'd had to cut along the adhesive so it wouldn't catch in the insertion device) because there's less of it to stick on your skin.

4

as batts mentioned, it's really about personal preference. i was MDI for 10 years and now i've been on the pump for almost 11. i have very good control with both methods. i simply prefer the covnenience of using the pump, as opposed to shots. i dislike having to carry insulin and syringes with me everywhere. the pump fits in my pocket, on my waistband, or in my bra.

because, ultimately, your son is one who has to live with diabetes, the decision to switch to a pump should be up to him. of course, it's very important for you as the parent to understand how to use the pump, but he will be the one who has to wear it. trialing a pump for a week or two is a great way to get an idea of how the features work and to become comfortable with the settings. keep in mind though, that when you trial an insulin pump it is typically just a saline solution, so you will be using both shots AND the pump. if he is really interested in the pump, i encourage you to look into all the available pumps in your areas. each pump offers unique features that may be appealing to your son.

the CGM is worn in a similar fashion to the pump (a small needle under the skin), but it works with a wireless transmitter as opposed to tubing. the device reading the transmitter needs to be kept within a couple feet of the transmitter in order to accurately interpret the readings. (i don't wear one, so this is just my understanding of it).

again, there are advantages to both shots and insulin pumps. do your research, discuss it with your son and your doctor. the decision should be left up to your son, but make sure he understands what wearing an insulin pump means as well as the options available to him. i prefer a pump out of convenience, but feel confident in my abilities to control my blood sugars under either method of delivery.

5

Our son was diagnosed 5 Aug 09. He asked almost immediatly for a pump. My wife and I was going to wait a year before getting him one (he is 12). He asked his endo at his first visit and the endo said any time he was ready. The main reason was because he spent a week in the hospital our deductables were met and we could get it for FREE, but we had to have all the paper work and pump shipped to us by end of Dec.  He loves his pump. So that could also be a factor is insurance will or won't pay for it all. We were also told if he does't like it then put it away and go back to DMI and try again later.

6

My son just started pumping in May and he just turned 4 years old. He used to get 6-8 shots a day. My main reason for trying the pump is the more accurate insulin doses. He hasn't had a low in a month! He used to have 2 or more a week. The tube hasn't caused a problem at all because he wears pump packs and keeps the tube tucked inside it. You don't have to worry about losing a programmer because you program the pump itself (except for the Omni Pod). We have the Ping, so I use the meter/remote to deliver a bolus, but you have the option to bolus directly from the pump. That would come in handy if we ever forget the meter. I would suggest signing up for a class to get more educated, you don't have to commit to anything right away.

7

I have been a T1D for 26 years and I still take shots.

I agree the decision to use a pump should be left to your son and his doctor. There are many people who have success with the pump. For others it just isn't for them, like me.

8

My daughter just got hooked up on the pump today.  One of the big reasons we went with it is the more precise dosing.  I hated when she would want a snack that was only 1/4 unit of insulin and I would have to make her eat more just so I could pull up an amount of insulin that I could see in the syringe! 

Her resons for going on it were-only 1 shot every 3 days, more flexibility in eating and she thought it was cool looking and liked all the accessories.  Since she was dignosed she told us she never wanted a pump but we went to a family diabetes camp and she tried an infusion set.  She was amazed that it did not hurt and from then on asked for a pump. 

Good luck with your decision, this website is a great resource for finding out real world opinions.

-Meg (mom to Emmie, diagnosed 10/29/09 at age 4)

9

I'm still on shots.  I don't plan to change any time soon either.  I've been doing it for 32 years and it works so I'm sticking (pun intended) with it.

Pumps are cool and great and everything, but they're not for everyone.  I've looked into and researched and talked to a lot of people and just don't wanna do it.  So, I'm not. 

Luckily today we have choices.  It wasn't always that way.

10

I can't tell you about kids and pumps, but I can tell you about my own experience and my technical knowledge about them. I was on mdi for for 37 years before going to a pump. I didn't want to be "connected" to something, but decided that I didn't care if I liked it or not, I wanted better control to ensure the longest life of my kidney transplant (don't worry, there is no reason that needs to be in your son's future). I had been told stories by well meaning people about pump malfunctions - "it's going to dump an entire vial of insulin in your system and you'll be lucky to survive." So I did some real investigation. I actually had friends who began pumping 30 years ago - in the early 80s. And at that time, malfunctions were more common. Nowadays, it rarely happens. I was pumping for 5 years and only had a couple of glitches (less than 1 per year). Once I didn't reconnect properly and when I tested 2 hours later, my sugar was sky high (that's why frequent testing is so important). Once there was a problem with the pump accepting a new battery so I made do with the old one for a day and the company sent me a replacement pump within 24 hours. On another occasion I had a problem with absorption at a site (again, constant high blood sugars) so I changed the site early and all was fine. Again, I found this through frequent testing.

I personally didn't find a lot of issues with my pump. It wasn't any more inconvenient than wearing glasses, but my pump didn't fog up when I came in from the cold. The advantages I found were that I could sleep in without worrying about taking my am shot. I could skip a meal (since I could tailor my basal rates more accurately than lantus works) and I could occasionally (don't want to do this too often or you'll get fat) have extra treats and simply bolus accordingly. Instead of multiple shots per day, it's one shot every 3 days (heaven! I was so tired of shots!). On those rare occasions where we had a large family dinner that extended for hours, it was simple to bolus after each course. So I could have a small bolus after the soup, bolus for the roll, the veg/potato at dinner, and then for dessert. It was easier to keep control that way. The other incredibly terrific thing is that you can control the insulin in very, very small increments. I was very insulin sensitive and so was able to deliver a dose as little a 0.1 units (basals come as small as 0.025 units per hour). Especially in kids you can adjust things much more tightly.

Your son will need to test frequently unless he opts for the cgms as well but that still does require some testing. Don't get me wrong, the pump does require a lot of work. You need to work out your ratios and since they can change, especially in a child, this will be an ongoing process. I found it all to be worthwhile. If your son wants to do it, I would give him the chance. It will provide freedoms but will also require responsibilities. And kids love gadgets!

Cora

11

My son is on shots and doing well with them.  He has looked into the pump but has chosen to stay MDI at this point.  His major reason is sports activities -- he is a pretty aggressive soccer player and does not like the idea of having to worry about the pump during games ( yes he could take it out while playing)  He really doesn't like the idea of something being attatched all the time.  His endo says that given how well he is doing with MDI that there would be no better control by going to the pump.  Cole is such a math wiz that figuring out carbs and doses is no problem at all...so he doesnt mind that part of MDI. I guess I look at it as entirely his choice - kind of like would you like your soda in a bottle or in a glass?  EIther way you get what you need right?   

I think the worst part for me is how people seem to assume that he should be on a pump - " my neighbor's niece is on a pump and it is so easy for them...."    Honestly, diabetes isnt "EASY" regaurdless of having a pump or not -- but it is manageable with either choice.  Choose what your team is comfortable with for now , the other option is always there if you change your mind .   

12

[quote user="awesomealex"]

.. but they really scare me.  ... I am very uninformed about the pumps so I need to go to a class and learn more about them.  [/quote]

go and look at them, no need to get up from your computer:

OMNIPOD

http://www.myomnipod.com/

Minimed

http://www.minimed.com/products/insulinpumps/

Animas PING

https://www.animas.com/Request-ping-pump-info?utm_campaign=2009%20Animas%20-%20Branded&utm_source=google&utm_medium=cpc&utm_content=Animas%20-%20EXACT&utm_term=animas%20ping%20-%20EXACT

yes they are machines, so the brutal honest answer is machines can fail.  I reviewed the safety records for mediucal products and decided the failure scenario was minor, and so it did not changing my mind.  I was on MDI for 29 years and now a pump for 4.  I am never going back because it works so well for me - because of the variable basal rate that can't be mimicked with "basal" insulin like levemir/lantus

[quote user="awesomealex"]

My doctor brought up a CGM at our last visit.  That attach's like a pump correct?    [/quote]

Yes.  The cgm is [attaches] a lot like a pump.   

http://www.dexcom.com/products/seven_tutorial

(but the dex 7 is not cleared for use for children)

[quote user="awesomealex"]

Just wondering if I am the only parent that still uses shots ?   [/quote]

nope!     good luck!

cheers

13

well i can say goodbye to shots on monday yay im geting the pump.

14

I have three boys under the age of 13 with type 1, and they are all on pumps.  Most people are VERY nervous about the change to the pump.  Heaven knows I was...it took my doc three years to convince me to put my son on one.  But once we started we knew we would never go back.  Biggest advantage? 1 shot every three days...instead of multiple shots a day.  Next biggest advantage  A more relaxed schedule.  Eat when you want, what you want.  If he wants one, I would for sure explore the options.  I promise it is worth it.  I have met dozens of families this year that have started the pump...VERY scared to do so...but VERY happy in that they made the change in the end!  Good luck!