Pump vs. MDI

[danismom79]

Not trying to start a war or anything, I know this can be a touchy subject. But has anyone had the pump offered and decided against it? I see so many people fighting for it, hoping and praying for it, etc. How many people have MDI working for them and are just fine keeping it that way?

My daughter was only diagnosed a month ago, but she's adamant that she does NOT want a pump. I'm in no rush myself, but I'd like to keep it open as an option.

[twodoor2]

Here's an insightful little thread you might be interested in.:cwds:

http://forums.childrenwithdiabetes.com/showthread.php?t=12784

[zell828]

It's a personal preference. The reason we are pushing for it now (SD wants it too, not just us) is to avoid all the shots. My SD especially hates the Lantus shot. She also wants the freedom with a pump. I hear it is better with the A1C numbers too. It's possible she may not like it, but I highly doubt it. You have to all be ready in order to make the transition, I think.

[Nancy in VA]

I know two families in my neighborhood that have chosen not to be on the pump. One is an 11 year old boy who doesn't want to be attached to his diabetes 24/7 and the other is a 5-year old in the same basic situation - she has a problem seeing people hooked up to machines so she doesn't want her child hooked up to one.

[danismom79]

Here's an insightful little thread you might be interested in.:cwds:

http://forums.childrenwithdiabetes.com/showthread.php?t=12784

Thanks. I also found a similar thread on the adults with type 1 board.

[coop]

At first our endo's office said we would have to wait six months before they would approve a pump but at our last appt 6 weeks ago they thought we were ready. Well it turns out DD is not. She does not want to even consider it yet. We did a demo pod and have gotten Cd's and info on other pumps. She hates the lantus shot too but I think she is terrified of the infusion sets and having something "hooked" to her all the time. As we are still in the honeymoon and doing OK on MDI we will stick with it for now. I feel at her age it is ultimately her decision. With that being said if I felt we needed to be on a pump I would find a way to convinve her to get one!:D

[georgia]

Our daughter turns 5 in June and we've been dealing with diabetes for almost 2 years. We are still MDI, our endo tells us we can have a pump whenever we want, but we plan to stick with MDI until our daughter is ready and wanting to change, or if we were to have a real hard time with the numbers. Things are going okay for now, she accepts and handles the shots fine.
There are some advantages to the pump that I would like, for example the fine tuning of the basal insulin and being able to prebolus some and then give the rest later,(without two shots). Unfortunately we have many many years ahead of us, I anticipate we will eventually go to the pump. But not now.

[thebestnest5]

It's personal and each parent/child will decide what is best for them. If something is working well, then sticking with that would obviously be fine.

Here's a small bit of our story. There's more...but I would have to do a lot more typing.;)

Liv had excellent A1C's on MDI and we didn't start looking at the pump, until we started seeing spikes of 300-350 around 1-3 am. That was one of the ways her honeymoon ended. The stable overnight numbers with Lantus was no more. It was miserable to have to give her 2 corrections a night to bring her numbers out of that high range. We felt that varied basals of the pump might be helpful. And, now this is just my opinion, I'm not judging anyone's management-IMO having more than 6 shots in 24 hours was just too much--for rotations-just too much period.

I had heard so many people say that they LOVE their pump. The best that I'd heard anyone say about MDI is that they were doing very well with it.

I wanted to see if pumping could truly be so much better for Liv and I told her that she would "try" the pump for 6 months and then, IF she wanted to go back to injections that would be OK.

As a parent, I am the one to make the important medical decisions, the buck stops with me. Age appropriate decisions are extremely important when it comes to something so serious as chronic disease medical care with possibility of horrific complications. Liv can definitely give me her input; but she could never tell me that she will stop doing injections and try to manage her disease with diet and exercise. I would nix that in a heartbeat. Liv wasn't given the "choice" to take injections or not--it was do or die:cwds:

So, I feel that giving her the choice to pump or not actually brought up different fears and maybe some past diagnosis fears and she felt a little control by saying "no" and that also helped the comfort level with a child's fear of change. I wasn't willing to put all of that on her shoulders; so I made the decison to try pumping.

And, after that....once she could make an educated decision about which was better for her--she could decide. But, I told her that it would be impossible to actually compare pumping and MDI when she had only done MDI. I also told her that she would get to make age appropriate decisions, regarding pumping stuff and we gave her those decisions to make. Just a couple examples were pump color, groovy patches, pump packs, pump clothing, etc...


Liv's has now been pumping for over a year and would not choose to go back to injections. She has thanked me more than once (seriously!!) for taking that decision out of her hands. She told me that (for her) making the decison to pump was scary and difficult and it was just easier to decide not to do it when it was more her decision.

[thebestnest5]

Here's a good thread with much discussion on pump and MDI.


http://forums.childrenwithdiabetes.com/showthread.php?t=11330

[LantusFiend]

I'm not comfortable asking for insurance to pay for anything that I don't think will really improve my health. I don't think that a pump is likely to improve my health. I have good control on MDI, I don't have a need for basals to be changed (no dawn phenomenon) and I really don't want the scarring.

[wilf]

We manage the D just fine on 4-5 injections per day. So there is no medical reason for switching (some families find they get better BG control with a pump).

DD is quite clear that she doesn't want a pump at this time, and we feel she is old enough that she should be making the call on anything non-medical related to the D.

There are interesting and varied benefits and drawbacks to both pumps and MDI. There are major drawbacks to old-style 2-injection per day regimens using NPH (unless your child is honeymooning big-time).

[Rick]

I have good control on MDI, I don't have a need for basals to be changed (no dawn phenomenon) and I really don't want the scarring.

What scarring are you referring to?

[sugarmonkey]

Yes, what scarring? Phillip has been pumping for nearly a year. He has marks after he removes a site, but they're gone within 1-2 days. Never any scarrring.

[Tigerlilly's mom]

Tyler is going onto 3 years since diagnosis, and has never had a desire for the pump. He says he doesn't want to have anything attached to him. Even though I am sure that the pump would be so much easier for ME, I will continue to respect his wishes regarding the pump. Mind you at the same time, he has never complained about needing a shot or testing, so his daibetes care is not an everyday battle for us. (well we have the highs the lows, the WTF's, but seems like pumpers have the same problems)
Personally, I think going or not going on the pump should be a joint decision between the child, parents and endo team and all parties should be in complete agreement or you are not going to get the benefits out of it.

[Tigerlilly's mom]

As a parent, I am the one to make the important medical decisions, the buck stops with me. Age appropriate decisions are extremely important when it comes to something so serious as chronic disease medical care with possibility of horrific complications. Liv can definitely give me her input; but she could never tell me that she will stop doing injections and try to manage her disease with diet and exercise. I would nix that in a heartbeat. Liv wasn't given the "choice" to take injections or not--it was do or die:cwds:.

Personally, I don't feel as though the "buck stops with me" when it comes to making decisions regarding Tylers medical care, his whole outlook on his disease comes from being a part of the decision making. I don't think that any sane parent would allow their child to make the decision to manage their Type 1 diabetes with diet and exercise, that isn't an option. The choice really isn't injections or not, it's injections or the pump. big difference. I am by no means "anti-pump" - I would love for Tyler to go on the pump, but only when he is ready. I want him to have some control in his disease and if the only control is pump or no pump and where he gets his injections, then at least he feels he has some control. He doesn't get to decide not to have his lantus shot, or breakfast, lunch or dinner shot - that is not an option.

[danismom79]

There are major drawbacks to old-style 2-injection per day regimens using NPH (unless your child is honeymooning big-time).

I've been hearing a lot of bad things about NPH, and I have no idea what to think anymore. My daughter was put on regular, NPH and humalog and that's what she's been on for the past 5 weeks. We have yet to see her endo (end of this month). She gets 3 shots/day: NPH & regular at breakfast, humalog at dinner, and NPH at bedtime. That way she doesn't have to worry about getting a shot at school. Now I'm not sure if it's working or not, or if we're getting wonky high numbers at random times for other reasons. It was fine for a few weeks. I'm also hesitant to change the schedule because she'll be going to the YMCA for summer camp and they don't have a nurse on-site. I don't feel comfortable letting a high school kid with no D knowledge draw up insulin and give her a shot at lunch.

Sorry, that was a bit OT.

[danismom79]

Personally, I don't feel as though the "buck stops with me" when it comes to making decisions regarding Tylers medical care, his whole outlook on his disease comes from being a part of the decision making. I don't think that any sane parent would allow their child to make the decision to manage their Type 1 diabetes with diet and exercise, that isn't an option. The choice really isn't injections or not, it's injections or the pump. big difference. I am by no means "anti-pump" - I would love for Tyler to go on the pump, but only when he is ready. I want him to have some control in his disease and if the only control is pump or no pump and where he gets his injections, then at least he feels he has some control. He doesn't get to decide not to have his lantus shot, or breakfast, lunch or dinner shot - that is not an option.

I feel that way too. I'd rather be inconvenienced than have my daughter be resentful and noncompliant.

[miss_behave]

I've been hearing a lot of bad things about NPH, and I have no idea what to think anymore. My daughter was put on regular, NPH and humalog and that's what she's been on for the past 5 weeks. We have yet to see her endo (end of this month). She gets 3 shots/day: NPH & regular at breakfast, humalog at dinner, and NPH at bedtime. That way she doesn't have to worry about getting a shot at school. Now I'm not sure if it's working or not, or if we're getting wonky high numbers at random times for other reasons.


I suggest you ask your endo to switch to Lantus. To some folks around here NPH is otherwise known as Not Particularly Helpful. NPH is notorious for its unpredictable peaks, making lows much more common than on Lantus.
If you read Jeff's Diabetes Care Suggestions you will find many many studies to support switching off NPH and Regular. http://www.childrenwithdiabetes.com/clinic/care.htm (http://www.childrenwithdiabetes.com/clinic/care.htm)

The best thing about Lantus vs NPH is that you can eat whatever you want, whenever you want, and just dose for the carbs. No meal plans, no set carbs, no HAVING to eat because of the nasty peaks.
NPH is old school. You won't find many fans of it here.

[momandwifeoftype1s]

Our endo's office was not recommending the pump for children under age 7, but at the last appointment two appointments they've asked me if I've started considering it for Connor (age 6). I've been trying to get Connor interested in a pump. He's met two kids with pumps, and he's been looking at pictures of the kids on the forum with their pumps. We've been showing him pictures of cool pump cases with dinosaurs on them. His school nurse has also been talking to him about how cool a pump is. But - he's very scared of the big poke at the injection site. He's seen the pictures of the size of the needle, and he knows from talking to the other pump users that the poke hurts more than Lantus (that's what the kids told him). Until he is comfortable with the idea of a pump, I'm not going to force it on him. Our endo has also stressed that it needs to be a family decision, and Connor is one of the opinions that counts. Our insurance is very good, so the cost is not too high for a pump for us. Our endo's office and school nurse are also encouraging. We are holding off on the pump until Connor is more receptive to the idea (maybe this summer?). In the meantime, he'll have some more play dates with kids who have pumps and I'll keep researching options. I'm also hoping that the closed-circuit loop pump/CGM (I think that's what it's called) will be available soon so he only has one injection site on his skinny body.

[hawkeyegirl]

Personally, I don't feel as though the "buck stops with me" when it comes to making decisions regarding Tylers medical care, his whole outlook on his disease comes from being a part of the decision making. I don't think that any sane parent would allow their child to make the decision to manage their Type 1 diabetes with diet and exercise, that isn't an option. The choice really isn't injections or not, it's injections or the pump. big difference. I am by no means "anti-pump" - I would love for Tyler to go on the pump, but only when he is ready. I want him to have some control in his disease and if the only control is pump or no pump and where he gets his injections, then at least he feels he has some control. He doesn't get to decide not to have his lantus shot, or breakfast, lunch or dinner shot - that is not an option.

I understand why you feel that way, and you son is quite a bit older than mine, which changes things a bit. My take on it is different than yours, however.

I believe that most kids are not the most rational decision makers in the world. Many times they will stick with the known because although it may not be good, it is better than the fear of the unknown. My son was scared to go on the pump, but it's just because he didn't know what to expect. I told him we were going to do it, we did, and he LOVES it now.

As he gets older, I will take his feelings into account, but I will make the medical decisions for him until he is old enough to do the research and logically determine what is best for him. (That doesn't mean that he has to come to the same conclusion I did. It just means that he has to have a logical reason, supported by something other than apprehension of something new.) I imagine that will happen sometime in the later high school years.

If my son hated the pump, I would give strong consideration to going back to shots. But if I wouldn't have pushed it, against his wishes, he wouldn't have tried it, and he loves it.

[danismom79]

The best thing about Lantus vs NPH is that you can eat whatever you want, whenever you want, and just dose for the carbs. No meal plans, no set carbs, no HAVING to eat because of the nasty peaks.

That would put her up to about 6 shots a day at least, I think, and that was what we were trying to avoid in the first place. Plus, she has scheduled meal times during the day anyway because she's in school (she's 9, not particularly fussy about eating).

NPH is old school. You won't find many fans of it here.

I noticed that on every board I've been on. And I'm so new to all of this that the negative feedback about it has me doubting myself terribly, even though it could be working (can't really tell as she may be in a growth phase). Aw, well.

[miss_behave]

That would put her up to about 6 shots a day at least, I think, and that was what we were trying to avoid in the first place. Plus, she has scheduled meal times during the day anyway because she's in school (she's 9, not particularly fussy about eating).

I noticed that on every board I've been on. And I'm so new to all of this that the negative feedback about it has me doubting myself terribly, even though it could be working (can't really tell as she may be in a growth phase). Aw, well.

The extra injections are a drawback of a basal/bolus regime. It is another reason why many choose to pump.

Don't doubt yourself! I'm sure you're doing great. If you're new to this, your child is probably honeymooning so this regime might work fine. It does for others regardless. Some people don't mind the scheduling and enjoy the fact they only need 2/3 injections a day. YDMV (your diabetes may vary) :cwds:

[saxmaniac]

That would put her up to about 6 shots a day at least, I think, and that was what we were trying to avoid in the first place. Plus, she has scheduled meal times during the day anyway because she's in school (she's 9, not particularly fussy about eating).

We would roll snacks into meal boluses with some success. We rarely did more than 4 shots a day on MDI. It does takes a little more planning, but it worked for us since the kids are not grazers.

I noticed that on every board I've been on. And I'm so new to all of this that the negative feedback about it has me doubting myself terribly, even though it could be working (can't really tell as she may be in a growth phase). Aw, well.

I don't want to knock NPH, and even if I did you shouldn't listen to me since I've never used it.

Some people do well with it. I think everyone should be informed of the different insulins out there, and the pros and cons of each of them. Only you can decide whether you need the flexibility of Lantus or less shots of NPH. If your endo is an NPH-only guy then there's a problem, as would be if he was is anti-pump. We started on Lantus but I bet if I had a good reason to use NPH, and I knew the drawbacks, our endo would let us.

[thebestnest5]

Personally, I don't feel as though the "buck stops with me" when it comes to making decisions regarding Tylers medical care, his whole outlook on his disease comes from being a part of the decision making. I don't think that any sane parent would allow their child to make the decision to manage their Type 1 diabetes with diet and exercise, that isn't an option. The choice really isn't injections or not, it's injections or the pump. big difference. I am by no means "anti-pump" - I would love for Tyler to go on the pump, but only when he is ready. I want him to have some control in his disease and if the only control is pump or no pump and where he gets his injections, then at least he feels he has some control. He doesn't get to decide not to have his lantus shot, or breakfast, lunch or dinner shot - that is not an option.



I did preface what I wrote by saying that this was our family's story.;) If what you do is working for you, then great!!:D Please don't take what I wrote as something that will work for everyone.

Here is a bit more about how my family handled this situation.

I choose to give Liv only age appropriate decisions regarding her medical care. This works for us and it is great!:D I chose not to tell my then 7, now 9 year old about the many horrible complications that can be part of Type 1 diabetes, because I felt that information was not age appropriate. Liv does not understand "why" exactly that she should try to keep her BG in range as much as possible---other than day to day inconveniences of highs or lows---she does not know there is so much more at stake for her quality of life in the future.

My daughter is allowed much input and we talk about all of her care; she is very involved. However, I don't burden her with information and decisons that I find not age appropriate.

Just like other parents know their child; I know my child. I knew my child would be hesitant to pump because of the fear of change and other reasons. So, I made the decisons to tell her...

1. getting the pump
2. she would try it for 6 months
3. she could then make and educated decision as to which method of insulin delivery that she liked better and why.

So, my DD got to make a very important decision; but I expected that decision to be made out of actually knowing both sides of what she was comparing--both MDI and pump--not just knowing MDI. I didn't want her to make a decision not to pump out of fear of change--which can be very common for children-fear of change. I feel (for our family) that was a huge! strength for DH and I to guide our DD into make an an educated and informed decision--something that will help her all her life--to be educated and informed about decisions.


And, just an FYI,
Liv's ICU nurse did tell us that Liv could manage her Type 1 diabetes with diet and exercise, not injections. :mad: I knew the nurse was dead wrong and I am so glad that Liv had just fallen asleep. I would have been so sad to have to tell Liv that nurse was wrong--after Liv got her hopes up.

[Jboudo01]

DD was diag 6 weeks ago. CDE asked us to consider pump. We are doing NPH only 2x day. Numbers are normally within in range. We are still honeymooning, they say. We've gotten creative with handling the pre-lunch lows. For example, she now has about 10 grapes of some Danimals yogurt before recess and she is fine. Although we would like the flexibility of being able to eat when she wants with pump - I personally think it is a big jump too soon. DD says one day that she wants pump, then the next day she doesn't. But I agree that it is too much pressure for 4yr old to make that decision. Shes' doing well with shots so we don't want to rock the boat. I think dealing with D alone is enough for now for her. While I would love to have the flexibility, I don't want to overwhelm her. Maybe in the next stage, after honeymooning, she and I will have different opinions. I've learned (thanks to this forum) to take it one day and step at a time.

[Mary Lou]

That would put her up to about 6 shots a day at least, I think, and that was what we were trying to avoid in the first place. Plus, she has scheduled meal times during the day anyway because she's in school (she's 9, not particularly fussy about eating).



I noticed that on every board I've been on. And I'm so new to all of this that the negative feedback about it has me doubting myself terribly, even though it could be working (can't really tell as she may be in a growth phase). Aw, well.

Please remember that many of us here on this board have been living with diabetes for some time.

We were on NPH at the beginning, too, and I'm thankful we were. I think if we would've walked out of the hospital with Lantus/MDI or a pump, we would've been overwhelmed.

Your regime is a good one to start one. It will help teach you the basics and provides a structure.

Our experience was, that once the fog cleared and we were able to wrap our minds around this disease, we realized that we were "feeding the insulin" and trying to live according to a schedule of insulin peaks that were very difficult for us. We hated having scheduled snacks and meals of a certain carb count. We hated having to wake our 6 year old up to eat on weekends. We hated all the lows caused by sports and play.

Give yourself some time to learn about different regimes. Read about the pump, about Lantus and see what your endo thinks. Our endo moved us to Lantus around month 3, and by month 6 we were pumping. It really works for us. There are so many different regimes b/c there are so many different lifestyles.

[Jboudo01]

WOW. You all have me really thinking again now. With NPH - I feel we are doing great. Only about 4 lows in 6 weeks. I know we are still honeymooning though. Now I'm wondering if I should ask to switch to Lantus and Novolog (which we have, but instructed to use only on doctor's orders, and we haven't had to use it yet) or should we just "wait" until honeymoon is over and switch? :confused:

[Jboudo01]

thanks! very good input. I will do some more research.

[Heather(CA)]

Not trying to start a war or anything, I know this can be a touchy subject. But has anyone had the pump offered and decided against it? I see so many people fighting for it, hoping and praying for it, etc. How many people have MDI working for them and are just fine keeping it that way?

My daughter was only diagnosed a month ago, but she's adamant that she does NOT want a pump. I'm in no rush myself, but I'd like to keep it open as an option.

Were in the same boat your in...Seth doesn't want anything attached to him and we do great on MDI so....I did tell him that he's going to try it sometime during HS so he knows his options BEFORE leaving for college;) I figure I'm going to send him to camp next year where he will get exposed to it w/o any pressure (Hopefully) Then we can go from there..

[saxmaniac]

WOW. You all have me really thinking again now. With NPH - I feel we are doing great. Only about 4 lows in 6 weeks. I know we are still honeymooning though. Now I'm wondering if I should ask to switch to Lantus and Novolog (which we have, but instructed to use only on doctor's orders, and we haven't had to use it yet) or should we just "wait" until honeymoon is over and switch? :confused:

If NPH is working for you, stick with it. There's no need to second guess yourself this early. If there's something you hate about it, you'll know it!

We started on Lantus/Novolog, which is pretty flexible, but were on a sliding scale instead of carb-counting. Hated it. But for us, the mechanics of carb counting, shots, testing, etc. was easy. The hardest thing for us to deal with was the inflexibility of trying to get a picky 4-year old to eat a fixed amount of carbs each meal! So we never had any of the problems Mary Lou mentioned.

That said, when it was time to move to the pump, Alex really didn't have any say. We were going to try it. We did ask, and he would always say "I like shots" and "I don't want a pump" despite seeing them on other kids. I agree with thebestnest, he really was incapable of making the decision for himself. He really couldn't understand the difference until he experienced it.

What happened? We put a dummy pod on him. After about 6 hours, he said "I like pods. This is my favorite pod. I want to wear it forever" and then started to tell us we needed to get the PDM to control it. He balked a bit at getting shots "why do I need shots if I have the pod?".

So we ordered the Pod. It took a few weeks. In those weeks, he reverted back to his original position: "I like shots. I don't want a pump".

We put the first real pod on him, and, bang, back to liking pods again. Maybe he has a possible career in politics.

[danismom79]

Please remember that many of us here on this board have been living with diabetes for some time.

We were on NPH at the beginning, too, and I'm thankful we were. I think if we would've walked out of the hospital with Lantus/MDI or a pump, we would've been overwhelmed.

Your regime is a good one to start one. It will help teach you the basics and provides a structure.

Our experience was, that once the fog cleared and we were able to wrap our minds around this disease, we realized that we were "feeding the insulin" and trying to live according to a schedule of insulin peaks that were very difficult for us. We hated having scheduled snacks and meals of a certain carb count. We hated having to wake our 6 year old up to eat on weekends. We hated all the lows caused by sports and play.

Give yourself some time to learn about different regimes. Read about the pump, about Lantus and see what your endo thinks. Our endo moved us to Lantus around month 3, and by month 6 we were pumping. It really works for us. There are so many different regimes b/c there are so many different lifestyles.

Thank you, that was helpful. Sometimes I just need to get a grip. I just got my copy of "Using Insulin" by John Walsh (I always think of the America's Most Wanted guy) that I will be reading on my commute to work for a while.

[wilf]

I've been hearing a lot of bad things about NPH, and I have no idea what to think anymore. My daughter was put on regular, NPH and humalog and that's what she's been on for the past 5 weeks. We have yet to see her endo (end of this month). She gets 3 shots/day: NPH & regular at breakfast, humalog at dinner, and NPH at bedtime. That way she doesn't have to worry about getting a shot at school. Now I'm not sure if it's working or not, or if we're getting wonky high numbers at random times for other reasons. It was fine for a few weeks. I'm also hesitant to change the schedule because she'll be going to the YMCA for summer camp and they don't have a nurse on-site. I don't feel comfortable letting a high school kid with no D knowledge draw up insulin and give her a shot at lunch.

Sorry, that was a bit OT.

Please don't take from my post that I am against NPH - on the contrary! It can be a great insulin if you know its limitations. We have been using it with great success for the better part of 2 years.

NPH is in particular great in that a morning injection can be used to cover lunch, allowing kids to be free of any D-related fussing at school. This is how we use it and it is how you are using it.

As long as it is working for you (with reasonable BG control and no unacceptable lows) there's no medical reason to change..

[Lee]

Please don't take from my post that I am against NPH - on the contrary! It can be a great insulin if you know its limitations. We have been using it with great success for the better part of 2 years.

NPH is in particular great in that a morning injection can be used to cover lunch, allowing kids to be free of any D-related fussing at school. This is how we use it and it is how you are using it.

As long as it is working for you (with reasonable BG control and no unacceptable lows) there's no medical reason to change..

Aren't you supposed to be in Germany or something on vacation?

[hawkeyegirl]

Aren't you supposed to be in Germany or something on vacation?

Yeah! Get off the internet and enjoy yourself! :D We'll all still be here when you get back!

[wilf]

WOW. You all have me really thinking again now. With NPH - I feel we are doing great. Only about 4 lows in 6 weeks. I know we are still honeymooning though. Now I'm wondering if I should ask to switch to Lantus and Novolog (which we have, but instructed to use only on doctor's orders, and we haven't had to use it yet) or should we just "wait" until honeymoon is over and switch? :confused:

As long you are doing great (numbers in range with few lows) there is no reason at all to change.

The time you think about changing your insulin regimen (whatever it may be) is when you can't make it work for you any more.

There are some people who can't get a pump to work for them, and they end up switching back to shots.. The important thing is to be monitoring carefully enough that you can tell when something isn't working anymore, and flexible enough to try something else when you've reached that point.

[Tigerlilly's mom]

Although Tyler is no longer on NPH, while he was on it, it worked great for us! We have always been pretty routine oriented anyways, so having to eat a snack and lunch at a certain time was no problem. If he wanted a larger than normal lunch or snack a quick injection would take care of that. I would say that Tylers great attitude towards his diabetes is in a large part due to NPH. It gave him the social freedom he needed. By this I mean he could go to friends houses for lunch or after school and eat with them without needing a shot for his food. It also made his trip to the nurse quick and easy all he had to do was test and as long as his number was in range, was off to lunch. Last year I gave his nurse a bag of syringes (10 per bag) and at the end of the year she gave me about half the bag back, which means he was rarely out of range at lunch. Sure he may have been a little low (70's or so) at times, but that just required him popping a few glucose tabs and then heading off to lunch. He never was late for lunch for his two years on NPH.
Since starting on the lantus/novolog, I did see a SLIGHT decrease in his A1c, but not enough for me to say, OMG we should have been doing lantus/novolog sooner!! Tyler receives his care at the Joslin Clinic in Boston and his endo was okay with him staying on the NPH, because it worked for him in many aspects, not just medically.
But again, whatever works for your family, is what is best for your family. Everyone has different experiences, opinions etc....

[wilf]

Aren't you supposed to be in Germany or something on vacation?

Trip got postponed. I was going to be taking our younger daughter and she had a bad fall from her bike a few days ago. Doctor wanted her to stay put for a few days to make sure everything is order, so we're off next week..

[danismom79]

Although Tyler is no longer on NPH, while he was on it, it worked great for us! We have always been pretty routine oriented anyways, so having to eat a snack and lunch at a certain time was no problem. If he wanted a larger than normal lunch or snack a quick injection would take care of that. I would say that Tylers great attitude towards his diabetes is in a large part due to NPH. It gave him the social freedom he needed. By this I mean he could go to friends houses for lunch or after school and eat with them without needing a shot for his food. It also made his trip to the nurse quick and easy all he had to do was test and as long as his number was in range, was off to lunch. Last year I gave his nurse a bag of syringes (10 per bag) and at the end of the year she gave me about half the bag back, which means he was rarely out of range at lunch. Sure he may have been a little low (70's or so) at times, but that just required him popping a few glucose tabs and then heading off to lunch. He never was late for lunch for his two years on NPH.
Since starting on the lantus/novolog, I did see a SLIGHT decrease in his A1c, but not enough for me to say, OMG we should have been doing lantus/novolog sooner!! Tyler receives his care at the Joslin Clinic in Boston and his endo was okay with him staying on the NPH, because it worked for him in many aspects, not just medically.
But again, whatever works for your family, is what is best for your family. Everyone has different experiences, opinions etc....

We're at Children's in Boston! I haven't met our endo yet, but the other little girl at my daughter's school has the same endo and CDE and her mom tells me we're in very good hands.

I'm at the point of keeping food logs and better notes on activities, etc. so I can try to see where I can make other adjustments before trying to mess with insulin (like maybe I should cut back on peanut butter during the early part of the day).

[Tigerlilly's mom]

[QUOTE=danismom79;172484]We're at Children's in Boston! I haven't met our endo yet, but the other little girl at my daughter's school has the same endo and CDE and her mom tells me we're in very good hands.

Are you in Mass? We live on the south shore. My good friend also goes to Childrens and loves her endo and CDE there.

[danismom79]

[QUOTE=danismom79;172484]We're at Children's in Boston! I haven't met our endo yet, but the other little girl at my daughter's school has the same endo and CDE and her mom tells me we're in very good hands.

Are you in Mass? We live on the south shore. My good friend also goes to Childrens and loves her endo and CDE there.

Yes, we live right in the city (Roxbury).