New to CWD - any advice on coping with a 2 year old who dosen't want injections?

[Liz2009]

Hello
I'm mum to 2 and a half year old Isabel (diagnosed at 20 months). This is my first time on the forum - just wanted some advice please.
Isabel is in the main coping quite well with her diabetes, however, she has a major problem with her injections.

At the moment she is having 2 per day of Novomix. She does everything she can to avoid having them (running away, tantrums, crying) and we do everything we can to make it easier for her. At the moment we are adopting a sticker chart reward scheme which works ok some days and not others. It is not a pleasant thing to do at any time but so much worse when she reacts like this. I have to hold her down most days which is upsetting for her and me!
I understand that this may just be the usual battle of wills and tantrums of a normal 2 year old (which is the comment I've had from clinic), but she has been like this since diagnosis.

Her sugars are all over the place at the mo-(unsure why, diet good, active etc). Her clinic have advised that she may have to go onto 4 injections a day to gain better control. I understand the need for this, but also have a feeling of dread that I will have to go through this upset 4 times per day.

Any advice welcome
Thanks
Liz

[Mistync991]

i would try the injectese as suggested in your other post or maybe check out the iport(i think this is the name) it is basicly like a pump site you just put the nedle in so your not sticking them each time and you can always use elma cream to numb it when you do the insertion ...if you do try this second one though be careful i dont think you can mix the basil insulin with the fast acting...and just be mater of fact this is going to happen dont give her time to think about it or run ...also the parents forum gets the most trafic whenever you have questions but the uk people do check this regularly

[Jackie UK]

Hello
I'm mum to 2 and a half year old Isabel (diagnosed at 20 months). This is my first time on the forum - just wanted some advice please.
Isabel is in the main coping quite well with her diabetes, however, she has a major problem with her injections.



Any advice welcome
Thanks
Liz

Hi Liz

Welcome to this forum. Its hard to come to terms with the shock of diagnosis, you grieve for your child. My daughter was four when she was diagnosed and was also on two injections a day. The way we dealt with problems of injections and the way other parents have told me that they managed, was to be as matter a fact as possible. The injections have to be done, full stop. So there was no fuss and not too much talk. We just prepared the injection and gave as quickly as possible with as little fuss as possible and that after got on with the next thing. Obviously when you have to hold a child down it is very upsetting. Try to keep the emotional tension down and quickly get on. I think that the sticker idea is great and I would continue with it. I know that there are lots of parents of young children on the UK CWD mailing list with children of the same age or who were diagnosed at this age. I will ask them to come and visit the board to reply to you.

Trying to control the BG levels on two injections a day is very hard. Although four injections seems like a lot a change in insulin regimen should give better control. Many clinics have stopped trying to force children to fit in with a simple two injection a day and moved to a regimen which gives better control and more flexibility. Children dont live rigid lives.

Hang on in there. I promise it does get better. Your world falls in when your child is diagnosed, if you make the diabetes journey with other parents its an easier trip.

[DebbieB]

Hi Liz,
Which areas are you using to inject? I found my son hated his thighs being injected but was better if he didn't 'see' the injection so we used buttocks mostly. I really sympathise with the having to pin your child down dilemma, it is heartbreaking and makes you feel awful. We went through this and like you said had good and terrible days. We went from twice daily to 4 times daily injections when Tom was 1 (diagnosed age 11 months) which did give better control and the extra injections did make them more 'routine' for Tom. I always found it best not to warn Tom too far in advance, get everything ready (we used syringes) out of eye and earshot and then do it as quickly as possible with lots of cuddles afterwards.
My main advice though would be to look into an insulin pump. My son Tom went onto 1 aged about 2 and a half. No more injections! How pro pump are your hospital?

[Melissasmum]

Hi Liz

My daughter Melissa is now 4 years old but was diagnosed at 17mths. For us the really hard part was the whole food and needing to eat issue. Also the mad levels and lack of control was very stressful. In respect of the injections I made myself very hard faced (I felt as though I had no choice). I would show no sympathy (in front of her anyway - would cry in private) and treat it like a very ordinary part of the day. She would get upset at first but I would treat this upset the same as if she was upset to get out of the bath, or having to stop watch TV or having to stop playing to get dressed, go out etc. I thought that at this age she had no idea of "normal" and so if I made this a "normal" thing that she had to do as part of her routine then she would accept it easier and she did. At one point we were on 5 injections a day and by this point no tears or tantrums.

For us life got a lot lot easier when we managed to get her on an insulin pump. She did not have to eat if she did not want to anymore, could eat as much as she wanted to when she did eat, her levels were much more stable and we only had to change her set every 3 days.

Melissa has now had diabetes for 3 years and at last I feel as though diabetes is just part of our lives, our lives are not ruled by it anymore. It will get easier.

Julia

[Liz2009]

Thanks for your responses.

[Liz2009]

I have asked about about a pump but told that she was a bit too young (!!) and that there is no funding in place in my area at the moment. I need to look into this further as I do feel it's the way to go for Isabel. We're at 3 month clinic on 30th so i'll discuss further with her health team.

We'll struggle on with the injections (no choice), just don't want her to get a phobia about it.

Thanks v much for your responses. It helps to know i'm not alone in this. x

[Jackie UK]

I have asked about about a pump but told that she was a bit too young (!!) and that there is no funding in place in my area at the moment. I need to look into this further as I do feel it's the way to go for Isabel. We're at 3 month clinic on 30th so i'll discuss further with her health team.

We'll struggle on with the injections (no choice), just don't want her to get a phobia about it.

Thanks v much for your responses. It helps to know i'm not alone in this. x

Hi Liz

I know that you are probably dealing with the diagnosis to think much about insulin pumps at the moment. However the fact is that if a consultant prescribes a pump, the PCT must pay for it. They cannot claim that there is no funding. Sometimes even the consultants do understand this or dont want to look into insulin pumps for one reason or another.



The is a patient led group called INPUT who can advise on how to go about getting a pump if you decide to go down that route in the future and a lot of parents on the UK CWD mailing list who have children on pumps. Some of them had referals to other hospitals to start on pump therapy. So when the time comes we'll be here if you need more infomation.

There is no age bar. Even babies can have insulin pumps. There are many toddlers in the UK with pumps now.

[DebbieB]

Where are you in the UK? We got our GP to refer us to St James's Leeds to get a pump although we live in Devon. I know UCLH, London also take out of area referrals.
I would recommend doing lots of online research about pumps and meeting very young pumpers. We meet the CWD email support group members on their annual camping trip 3 years ago (first bank holiday weekend May)and haven't looked back. I wish everyone had the opportunity to try pumping insulin as it has been 100% life changing for the better for Tom. Tom was 2 and a half and had no problems with a pump. I must admit I was horrified of the thought of him being attached 24/7 to something but it's just like wearing socks now (almost exactly as he takes his socks off for the bath too LOL).
He would never even wear baby reins but the pump is part of him and he's really protective towards it. It does make me gulp sometimes in the morning as the first thing he does is check it's in his belt pouch as he knows sometimes Mummy takes it out in the night to change insulin basal rates going in. He has worked out I don't always put it back and he hates jumping out of bed and it falling to the floor.
I wish we had the opportunity to get Tom his pump aged 0/1, it would have cut out all the problems we had with injections. It's great he doesn't associate food with mummy injecting him now.
Still do your research and get there in your own time x

[sabrina]

Hi Liz,
I am mum to a 20 month old, who was diagnosed at 13 months. we had exactly the same difficulties as you with giving the injections - dylan would get very wound up at the anticipation of being injected, and like you we had very poor control even with around 7-9 injections a day with every snack and meal.

After 4 months of injections, dylan went on the pump and his quality of life has improved beyond recognition. we change the set every 3 days and he has now got used to that, we would never go back to injections.

If you read up on pumps and you really think it is the way forward for you then I would really encourage you to go for it. our local hospital didnt feel confident starting dylan on a pump so we were referred to st james in leeds who are fantastic. funding is not an issue due to recent NICE guidelines, so please don't be fobbed off with this.

hope I don't sound too pushy about the pump but it has changed our lives and although you may have to battle for it, it is worth it in the end and has to be better than injections.

good luck

[Liz2009]

Thanks guys - your advice helps.

I asked at clinic and whilst they did not totally try to put me off they did say that it would be a lot of hard work for us (as if it isn't already!). They want to continue with 2 injections of mix but change the dosage. We've done this for nearly a week now with no positive changes to Isabel blood sugars (however she has been ill so prob not the best week).

I will continue to do what they advise me, but will also do my own research into whether I believe a pump is the best way to go for Isabel. If I do think it's best then I'll go armed with information, mainly from yourselves; so thanks v much.

Also regarding injections - Isabel gets lots of bruises at injection sites. I rotate sites and am careful not to press too hard (which can be difficult sometimes when she's wriggling about). Is this normal? Her nurse said it's just when I hit a blood vessel or press on too hard. I can't avoid hitting a blood vessel but I am really conscious of my pressure.