Toddlers and pumps

[Melanie]

my daughter is 3 1/2 years old. I have asked this question so many times but I would really like to hear from parents of toddlers that are on the pump. She is getting up to 5 injections a day, and I'm just wondering if the pump would be easier for her. She does very well with the injections and is doing well. I just wonder if there is a better age for the pump, if I should wait and let her decide, or just try it? Any comments would help!:confused:


Melanie

[wendyc]

Hi,

Our daughter was diagnosed this past June, and we are going to start pump therapy after the first of the year. We are starting our pump evaluation in December. Feel free to contact me.

Wendy
mom to Abby age 4 diagnosed 6/05

[Ellen]

Here's an article you may enjoy reading

http://www.tonawanda-news.com/homepage/images_sizedimage_317172249/xl

051113 Diabetes 01 - Tonawanda News DENNIS STIERER/STAFF PHOTOGRAPHER Town of Tonawanda, NY - Mary Lu Cohan checks the inuslin pump of her son, Aaron Cohan,2, who is the youngest person in Western New York to receive such a pump.


http://www.tonawanda-news.com/cnhi/tonawanda/homepage/local_story_318003525.html?keyword=leadpicturestor y

Constant care
By Stacey Shepard
The Tonawanda News
Town of Tonawanda — Not many toddlers know how to say the words “diabetes” and “insulin,” but 2-year-old Aaron Cohan does.

That’s because two months after he celebrated his first birthday, the Town of Tonawanda resident was diagnosed with Type 1 juvenile diabetes.

“He went from a bottle to diabetes,” his mother, Mary Lu Cohan, said.

Type 1 diabetes, a life-threatening autoimmune disease, occurs when the body for unknown reasons stops producing insulin, a hormone necessary to regulate blood sugar levels. Without insulin, blood-sugar levels can reach dangerously high levels that can lead to blindness, circulation problems and, in extreme cases, unconsciousness and death.

For Aaron, living with diabetes over the past year has meant that the toddler has had to face needle injections twice a day and finger pricks to test the amount of sugar in his blood as many as four to six times a day. In addition, Mrs. Cohan and her husband, Al, had to feed Aaron at specific times of the day, which made for a difficult situation when the toddler complained of being hungry an hour before he was scheduled to eat. Or worse, the Cohans said, when Aaron refused to eat.

“It’s a constant struggle. They have to count every calorie the child eats,” said Karen Swierski, executive director of the Western New York Juvenile Diabetes Foundation.

But that changed recently when the Cohans decided to switch from giving their son injections to putting him on an insulin pump, a newer device that works like a feeding tube and provides a more continuous supply of insulin to the body.

In doing so, Aaron became the youngest Type 1 diabetic in Western New York to use the pump.

“The pump allows more flexibility so the family can live a more stable life,” said Swierski, adding that the pump has become an increasingly more common means of treating the disease in the past five to seven years. “But you have to have parents that are willing to do it.”

While the device has been around for about 10 years, it used to be the size of a briefcase, she said.

With technological advances, it’s now about the size of a pager with a clasp that allows it to be attached to a belt or waistband. The pumps works by delivering insulin in small, continuous doses to the body through a thin plastic tube attached to a needle that is inserted into an area of the body with high fatty tissue.

According to the Cohans, the effects of switching to the pump have been dramatic.

While the device essentially performs the same function as the injections — it delivers insulin to the body — the continuous supply has regulated Aaron’s blood-sugar levels. This is in contrast to before, when his levels would fluctuate from extreme highs to extreme lows, the Cohans said.

Even though the pump still requires the use of needles, the infusion site is changed about every two days, reducing the number of times Aaron is poked each year from more than 700 times to about 150.

But more importantly, the Cohans said, the pump has meant a big lifestyle improvement for their son and them.

With more stabilized blood-sugar levels, Mr. and Mrs. Cohan have noticed that Aaron talks more and displays more energy.

“Before, he didn’t say much of anything,” Mr. Cohan said.

The family also has been able to move away from the rigid schedule they had before now that Aaron can eat almost anything at any time of the day.

And the “nerve-wracking” feelings for Mr. and Mrs. Cohan have subsided somewhat.

“It’s minimized the stress a lot,” Mrs. Cohan said.

Contact Stacey Shepard at (716) 693-1000, Ext. 114.

[BrendaK]

My son started the Cozmo pump in January 2005 when he was 4 1/2 years old. It has been wonderful for us. I had a lot of initial concerns and anxiety about the pump, but the transition was very easy. He was also on 4-7 shots a day. He wears a pump-pouch (like a fanny pack) with his pump in it -- I would highly recommend that for a toddler. It makes getting dressed and going to the bathroom much easier because you don't have to worry about the pump falling off or the tubing getting caught. The pump has allowed him much more flexiblity with his eating schedule and I feel so much better that I don't have to give him extra shots for snacks. Feel free to email me if you have any other questions. The pump is definitely as much (or more) work as shots -- we still check blood sugars 8 or more times a day and count carbs, etc., but for us it has definitely been worth it.

[maverickmom (Kerri)]

Great story...but they got one detail wrong...the pump has been around for at least 20yrs, probably a little longer though. :) I can't imagine having a toddler with diabetes...I'm thinking a pump would be extremely helpful with their unpredictable eating habits (it was bad enough with a 6yo!)!

[mischloss]

Hi Melanie,

Have you looked into insuflon? You can get information on it on www.hypoguard.com. It is basically like the "patch" end of the pump but without the pump. You put it on her tummy and another small tub comes out of the patch into which you "inject" her insulin shots. The end is like the rubbery end of the vials and "self seals" so it is waterproof. You replace the patch every 3-5 days. I am researching this as an alternative to having my 10 year old son "tethered" to the pump 24/7. He is still on his honeymoon phase and doesn't need as many shots as your daughter (2-3 a day). And this patch is pretty discreet in that is would be on his tummy under his t-shirt with out a pump clipped to his belt. Just thoughts that you might want to consider as a safe alternative. Hope this helps. Maria

[melissabeth]

Hi Melanie,
I'm new on the forum. My son is 13 months old and was diagnosed in September. We plan on switching to the pump in January because it's been nearly impossible to keep his sugar at a good level and we've had a couple of nasty scares, like yesterday when he threw up his lunch after getting his insulin shot...We spoke to another family who put their two-year-old on the pump a few months ago, and they said it was stressful at first, but that now they're much happier. I'm a little worried that my son will try to take it off somehow (I can't even get him to keep his socks and shoes on!), but we're looking forward to trying it. I'll let you know how it goes.
Melissa

[Holly]

been on the pump for over a year now and there is no comparasion "to us" b/w the two. Of course you will get different opinions but I've never met a parent of toddler with diabetes that has put their child on the pump to say that they wish they hadn't or went back to shots.

My husband has also been on the pump for 5 years and loves it.

For us it wasn't a hard decision at all. 4 shots a day or one little one every 3 days, better control and more flexibility. What is also great is that you can easily correct a higher bs with just a little bit of insulin, at the touch of a button. No waiting for the next shot to bring down their sugar.

Anyway, good luck with your decision.

[Brensdad]

We started Emma on her pump when she was 13 months old, and it was a Godsend! She doesn't pay any attention to it, and it has given us incredible BG control. She's on the Paradigm 715, which has a VERY useful bolus wizard built into it. Once you get a handle your child's glucose and insulin sensitivity, it works like a dream!

[Rhonda]

Hi as a mother of a 3 yr old daughter she was dxd 3/17/05 and we just received her insulin pump this tuesday we know it will be a little scary at first but we are oh so ready to begin pumping and Lilly is excited about it as well she got the medtronic mini med paradigm 522 with quikset infusions we are excited
and we are waiting for the pump reprsenative to call so that we can go for our pump training wish you and you family the best.

[Momof4gr8kids]

We just put our 5yr old DD on the pump. She was dx'd in Jan. I love the control it gives us, and how easy it has been to maintain good b/gs. There a few toddlers whos moms are on this site who have started pumping very early. I think it wouldbe easier with a little one.

If you are worried about the pain, or the set coming out, or how hard it is to wear you can do a trial with saline in it. Either you, or your child can wear the pump. I would suggest talking to your endo about it, and see what s/he says. Some people swear by the pump, you can give such small amounts of insulin in comarison to the half unit syringes, and it makes life easier for those in the end who do swear by it, but then there are some who don't want anything to do with it because they feel like it is a leash, or that it makes their D to noticeable, and that is ok, too. It really depends on what you want, and need, and what your prefrences are.

[Kirsten]

Hi Melanie,

I'm a big fan of pumping. My son, Griffin, was dx at 18 months and started pumping in June at 2.5. The flexibility and control were a godsend!:D I'll be happy to answer any questions you may have.

Kirsten

[Sari]

Hi, our son was 22 months old when diagnosed and left the hospital with his pump. We have the Minimed and he too wears it around his waist in a fannypack type pouch. It never really bothers him and he usually won't touch it. Sometimes he likes to experiment with the zipper, but he usually doesn't touch it. He has never had a problem sleeping with it either. He either just sleeps on it or it turns as he rolls over. He even is sad when we take it off for bath time. These Toddlers are so amazing - they really let nothing get in their way.

Goodluck with your decision.

[Pammers]

Joey has been pumping since June (he was 3 at the time) and we love it. It gives us better control and lets Joey eat more like a normal kid.

Joey has been fighting off an illness the last 3 days and the pump has really come through as far as that is concerned. It is so easy to program in a correction and temporarily increase his basal rate to compensate for the higher blood sugars that come with an illness. It was the first time in months that he had a BG of over 300 - I was still worried but the pump really has helped handle the situation. I don't know what I would do without it.

[hrermgr]

We're going to the pump in January for Teagan. Our endo clinic highly recommended it for many reasons including smaller insulin doses, more control, less shots, etc. We were a bit skeptical at first but when we put the pump on Teagan as a trial for two days, she didn't even notice it was attached! Now I'm check out pump accessories, which is kind of fun! I figure if she's going to be attached to one, she might as well be stylish!:)

[CarrieP]

Our little one was diagnosed at 18 months and pumping within a month of her second bday. I had to fight for the pump because our endo is a bit 'old school" and said that it really was for older kids.

I had to do lots of homework to prove that we were ready for the pump, but it was worth it!!! I highly recommend it, whether traditional pump therapy or "untethered". We are currently doing the traditional 24/7 pumping, but considering going untethered.....

CarrieP

[Ben'sMommy]

Hiya,

Ben was 14 months when he started pumping. It's been a joy. I think the younger the better. It takes a bit of getting used to but is much easier on little bodies than injections.

:)

[Kaylee's Mommy]

My daughter is 3.5 years old and started pumping in July.. she was dx 1/31/06. the Pump has been a HUGE lifesaver for us.. Her levels have evened out so so much.. her A1c in August was 8.4 and in the very beginning of Nov it was 7.5, Her endo is so happy with that number... The pump isn't something that is 'plug and go' though.. its a heck of a lot of work.. we've gotton our fair share of trouble in the few short months that we've been pumping, including one weekend we had to take her off of it all together and have a new one shipped out because we just couldn't get her down.. we never did figure out if it was the pump or something else that was causing her to be so high, but the pump company (minimed) didn't want to take the chance so they sent a new one out to us..

before the pump we had such an aweful time trying to control her BG.. we were usually in the upper 200s and lower 300s.. because Kaylee is insulin sensitive and hard to control we had to waituntil she was over 400 to correct her with a syring (it would be .5U) and even then sometimes she'd bottom out.. with the pump we can correct by .10 of a unit.. so much nicer..

She does not bother with the pump.. she doesn't play with it, and her sister (4.5years old)doesn't play with it either.. when we 1st got the pump we actually had her wear it right away.. which I was nervous about, incase she lost it LOL.. since it wasn't actually stuck to her.. but I wanted to slowly get her use to it.. she loves all the pouches she gets to pick out.. the only thing she doesn't like is when I take the IV3000 off and wipe off the emla cream.. that IV3000 is very sticky and hurts when I take it off..

if you want to email me I'm at mjckjc@adelphia.net I have been ahving a lot of trouble with my internet, it does seem to be OK right now..but if I don't answer right away thats why..

[wellsfamily]

Hi - Aidan had just turned three after diagnosis (actually today is our one year anniversary!) and six months into it, we started pumping. The shots were unbearable for us and a total nightmare. I really didn't think it was any way for a toddler to live/eat. We use the Animas pump and love it. Not one single complaint. Also, I am not sure what your endo is telling you, but ours definitely did not push or even suggest the pump. Only after going to the CWD conference last year in Phila, did I realize that there is absolutely no reason that they have to wait a certain amount of time. I basically told CHOP to either put us on the pump or we will go somewhere that will. Good luck w/ your decision and feel free to email me w/ any questions.
andyheatherwells@earthlink.net

Heather Wells

[Val]

Another thing to keep in mind...once they get a little older they may be so used to injections, that they are "afraid" (for lack of a better word) of trying the pump.

I have a 2 1/2 year old diagnosed at 20 mos. We just started pumping in October & I wish we would have done it months ago. Particularly b/c he just had a really crazy honeymoon spurt this last week. If he were still on Lantus it would have been almost impossible to manage. We were able to simply turn it off for a few days.

The most important benefit to us has been the improvement in his temperment - he is a different kid now!! PUMP PUMP PUMP!!!!

[lisalotsamom]

Our daughter will be 4 in January, and has been pumping almost a year exactly. She was diagnosed at 18 mos, and was on MDI--usually 4-5 injections/day.
The pump has been so much better for blood glucose control for us. We are no longer tied to a strict time/carb amount schedule for her meals and snacks. It is so difficult trying to get a toddler to eat when she doesn't want to, especially at specific times and always seemed like I was "feeding the insulin" and not feeding my daughter. Plus, it makes it easy to give her corrections, especially at night when she's running high.
That said, it is alot of work, probably more blood sugar checks, site changes, etc, but I wouldn't go back to injections.
She doesn't mind the pump at all, shows it to people when they ask, but otherwise pretty much forgets that it's there. She is careful when going potty, and reminds me, "watch my site" when we are pulling pants up and down.

[TaeandTiff]

We haven't even hooked up to the pump yet and I cant wait.:D We start the saline on tuesday. I know 1st hand what controlling D is like and even though I was on top of my shots for 20 years, I missed the bus somehow. I will do whatever it takes to get better control ad PREVENT all of the complications I went through, for my Ayden. And I believe that pump therapy and CGM are 10 steps ahead of what I had in the 80's and 90's!

[payam7777777]

...insuflon...

Insuflon is good. Even better is I-Port. I-Port doesnt have the 'dead space' problem, i guess.



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The I-PORT™
http://www.medgadget.com/archives/2006/09/the_iport.html

http://www.pattonmd.com/product/

http://www.pattonmd.com/product/howitworksvideo.php?sel=mov-low&submit.x=46&submit.y=13&submit=Play&hasjs=true





















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; Insuflon -Pages ;
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Insuflon *IMPORTANT... READ THOROUGHLY
http://www.betamed.se/eng/insuflon_html.htm

Do you find your insulin injections painful?
http://www.betamed.se/eng/insuflon.htm

Subcutaneous cannula *GOOD
http://www.ich.ucl.ac.uk/factsheets/families/F030071/

Insuflon
http://www.childrenwithdiabetes.com/d_06_311.htm

Unomedical
http://www.infusion-set.com/Default.asp?ID=118

insuflonTM testimonial
http://www.infusion-set.com/Default.asp?ID=184

insuflon multi-injection therapy aid
http://www.futuramedical.com/insulfl...n_therapy.html

Insuflon Subcutaneous Injection Port
http://www.applied-medical.co.uk/insuflon.shtml
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; Insuflon -Forum Threads ;
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Anyone Using Insuflon Patch for Child??
http://forums.childrenwithdiabetes.c...light=insuflon
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; Insuflon -Excerpts ;
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Donika, 3 years, sits in her mother's lap when she gets her injections. If she is hungrier than anticipated, she will just get an extra injection in Insuflon after the meal without any extra pain.

We usually change the insuflonTM once a week and apply EMLA topical anesthetic cream for one hour, under a band-aid, before insertion.

Q: Do I need any additional adhesive for Insuflon than supplied?
A: The adhesive supplied is made of hypoallergenic cotton. This keeps Insuflon safe in place even during physical or water activities.
Q: Can Insuflon be used with insulin pens:
A: Yes. Insuflon is ideal for injection of insulin using an insulin pen as well as a syringe.
Q: Can different insulins be used with Insuflon?
A: Yes -- as long as the insulin manufacturers' instructions allow their short acting and long acting insulin types to be mixed, there are no problems of injecting different insulin types through Insuflon.
Q: What gauge is the introducer needle?
A: 27 gauge.
Q: How often should the Insuflon be replaced?
A: It should be replaced every 3 days.
Q: Does the Insuflon port need to be sterilized before each use?
A: No. The added ingredients in insulin prevent bacteria from growing.
Q: Can the Insuflon be worn while swimming?
A: Yes. Insuflon has a self-sealing membrane inside the port that prevents water from leaking in.

It looks like an
IV but goes under the skin instead of into
the vein. After the catheter is put in, the
needle inside it is removed. The catheter is
secured and can stay in place for 3 to 7 days,
depending on which medicine is given.

One thing I'd recommend is that if you see any sign of bad redness or hives/itching after you've put the Insuflon device in, to have a doctor check to see if its a latex allergy. I've also heard that putting a small piece is soft gauze underneath the plastic "wing" part of the device helps to reduce pressure soreness.

The dead space of the catheter (the hollow inside that will be filled with insulin with the first injection) is half a unit of insulin in a clinical setting.

Sometimes the blood-glucose level will rise after a few days use of an indwelling catheter. If this happens on a regular basis, there are often signs of lipohypertrophy present. We then instruct to replace the indwelling catheter at shorter intervals.

Studies of insulin pump users have shown both an unchanged insulin absorption during 5 days' use (5) and an increased absorption after 3 days' of using of the same injection site. Studies from Finland with indwelling catheters show no change in insulin absorption during 5 days of use. (7). A Swedish study using radio-actively labelled insulin did not show any change in absorption during 4 days' use of indwelling catheters.

It can remain in the same place for up to seven days. After that a new subcutaneous cannula should be inserted into a different site.

In the first few hours after the subcutaneous cannula is put in, your child may feel a slight irritation at the place where it has been inserted. This is quite normal and usually disappears. If the pain or discomfort continues, tell your child’s doctor or nurse. He or she will have a look at the area and may need to remove the subcutaneous cannula.

The insertion site may bleed or become bruised. This is not normally a cause for concern, but you should tell your nurse if it happens.

Skin around the insertion site may appear red – this is quite common and can be caused by the adhesive pad or incorrect placing of the subcutaneous cannula.

The Subcutaneous cannula may become blocked, knocked out of place or twisted. If so, it will need to be removed and replaced with a new one.

The “wings” on the subcutaneous cannula may cause discomfort or irritation. Padding underneath may help to solve the problem.

Infection. This is very rare but if you notice redness around the subcutaneous cannula site or the skin there is warm, please tell your doctor or nurse.

You should check the insertion site every day for signs of redness, swelling, skin irritation, pain or discomfort. If you notice any of these, you should tell your child’s doctor or nurse. The subcutaneous cannula does not need flushing after use like other devices.

I can give you the email of one Mum who has used and loved them for several years if you would like. Their insuflon lasted 7 days before changing.

[Eoin'sMam]

Eoin was diagnosed at 16 months and at 26 months he went from 3 injections a day to the pump...He's now been pumping 7 months and it is AMAZING

How do we love it...let me count the ways :-)

1) one site change every 2-3 days versus 3 injections a day...no more running around the house after him and battling (oh the guilt I felt)

2) Freedom - he can eat what he wants when he wants - a BIG thing for any 2 year old

3) Freedom in lifestyle - no more forcing him awake to eat his breakfast...he can have a lie in if he likes (mind you it never seems to happen at the weekends :-))

4)Control.- If he's sick you just adjust his basals up, having a manic running around day, reduce them down, mad high for no reason - give a correction - much less panic and more instant results

5)Way improved A1C's - gone from 10's to 7.1 and still on the way down

6)Fewer Hypos - heaven

7) Happier child - there is no greater benefit than this

8) More relaxed Mammy - A win for all

I could go on...but I don't want to bore ye. I would defintely recomend it especially for toddlers

Lou