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Thread: Is 6 mos to 1 yr delay between dx and pump typical? Why?

  1. #1

    Default Is 6 mos to 1 yr delay between dx and pump typical? Why?

    i spoke to my endocrinology clinic Friday and was told they won't even consider a pump for 6 months to a year after dx because of potential honeymoon.

    does that make any sense? Did other pump users have to wait an arbitrary amount of time?

    Thanks!
    greenpalm

    My parent of CWD blog: Girl Glycosylated

    We are autoimmune rich at our house:
    DD born 8/8/06 T1D dx 3/10/13
    DH born 2/65 T1.5D AKA LADA dx 1/99, & Addison's Disease dx 8/07
    DS born 9/15/03: multiple food allergies dx 8/05 & Periodic Fever Syndrome
    Me: Spondyloarthritis
    DS born 8/24/00: Penicillan allergy

    Homeschooling

  2. #2

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    We had to wait due to insurance. At the 6 month mark I was on the phone getting the ball rolling. By the time everything was complete and we had training, it was 8 months (a bit longer for us because of the holidays).

    My daughter was honeymooning while pumping. Our doctor felt it was more helpful to be on the pump because we had the luxury of reducing basal or turning pump of completely, and of course having different basal programs based on time of day. For example, my daughter was extremely insulin sensitive in the afternoon, so she barely got any, yet in the am, she needed more. My daughter was honeymooning for 18 months, and there was no way we were going to wait that long!!!

    Some doctors feel that a wait is needed because the family needs to get used to doing shots and carb counting. Honestly, after a few weeks, we were comfortable. Day one of meeting our doc we told her we wanted a pump and she was fine (our friend is on one so we were familiar with it) and gave us info that day. Some have antiquated views on D care. You need to do your research, go armed to your next appointment and be firm. If they say no, start looking for another doctor.
    Diagnosed June '05
    Pumping since Feb '06
    Animas Ping
    Dexcom Study







    My current position:
    CIO...CHIEF INSULIN OFFICER

    "Life is under no obligation to give us what we expect"...Margaret Mitchell

    "Make it work"...Tim Gunn

  3. #3

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    We had to wait 6 months. It was about 9 months before we were up and pumping. Our clinic's reasoning was that they wanted us really familiar with carb counting and giving insulin with shots so we would know what to do if the pump failed and we had to go back to the old fashioned way.

    At the time, it completely annoyed me and I felt we were ready sooner. Now, I'm glad we did it and I'm comfortable with shots. However, now that my son is pumping I don't think we'll ever go back. He really loves having the pump and it has made managing diabetes so much easier for us and less obtrusive for him.

    FWIW, we go to a large hospital for care, and they have a very standard way of doing things and do not like to deviate from their protocols at times. You may find a different answer by going to a different endo.

    My only advice would be to make sure you are really comfortable with carb counting and giving shots. It is a learning curve, and although it makes it easier in the long run in the beginning it's a lot to learn.

    Good luck with your decision!
    Mom to DS, 11
    Diagnosed 3/2011 with Type 1
    Pump: MM Revel 12/2011, Omnipod 3/2013
    MM CGM 3/2012, Dexcom G4 3/2013

  4. #4

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    Our practice told us 6 months after diagnosis, to have time to become very proficient at carb counting, dose calculations, and such. Ididn't really know enough to question it, but thought it was weird that it was so cookbook. My husband and I both work in the medical field, so shots, calculations, highs/lows aren't unfamiliar to us.

    At 6 months, I asked, and they seemed surprised, but set us appointments to meet with the CDEs to discuss options. They had a specific pump in mind, and I was interested in a different one. I wasted another month convincing them that an Omnipod would work for a 2 year old. We got the prescription written, and then waited another month or so to do the saline trial they required, then to be in the pump start-up class they required. After all was said and done, we were pumping about 10 months after diagnosis.

    We had the same sort of go around when we finally had insurance to cover the CGM. This time, I knew more about the system, and insisted on the CGM we wanted, and if we could not have it, would transfer out of the practice.

    I think 6 months is arbitrary, and needs to be adjusted based on the family's ability to use a pump and understand the basics of insulin dosing. The requirements for specific time frames, intro classes, and such need to be tailored to the family, not blindly applied to all.
    Jen
    Mom to Christopher, age 5, dx 1/6/2009 at 20 months.
    Omnipod with Novolog since 10/12/2009

    And now, Mom to Benjamin as well!

  5. #5

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    Quote Originally Posted by minniem View Post
    My only advice would be to make sure you are really comfortable with carb counting and giving shots. It is a learning curve, and although it makes it easier in the long run in the beginning it's a lot to learn.
    Agreed. That's why many refer to MDI as pumping without a pump. You are essentially doing what the pump does, just via shots (of course you can't tailor the long acting like a basal program, but you are doing carb ratios).

    One additional thing is when you start pumping, it doesn't magically fix everything. As pp says, there is a learning curve. In the beginning there are many changes in order to get the right balance for the pumper. But, it does get a bit easier.
    Diagnosed June '05
    Pumping since Feb '06
    Animas Ping
    Dexcom Study







    My current position:
    CIO...CHIEF INSULIN OFFICER

    "Life is under no obligation to give us what we expect"...Margaret Mitchell

    "Make it work"...Tim Gunn

  6. #6

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    Our endo pushed the pump from day 1 so I think it really depends on the philosophy of your office.
    For us, starting during my son's honeymoon was the best thing we could do because his insulin needs were so small, we could give much smaller doses with the pump. On MDI he was down to .5 unit of lantus and his insulin for food was so often less than half a unit- with pens we could only give 1/2 or 1 unit and then on the pump he could get .2, .8 exactly what he needed.
    Rosemarie

    Mom to:
    William, age 11, diagnosed 11/10/11, MM CGMS (2/20/12), MM revel blue (4/4/12), Dex G4 (11/22/12)
    James, age 8, nonD
    Grace, 7, nonD

  7. #7

    Default

    Quote Originally Posted by greenpalm View Post
    i spoke to my endocrinology clinic Friday and was told they won't even consider a pump for 6 months to a year after dx because of potential honeymoon.

    does that make any sense? Did other pump users have to wait an arbitrary amount of time?

    Thanks!
    Insurance dictated it for us, 6 months, and it was right at 9 months when we were pumping. I personally believe that it's a good idea to be skilled at MDI before going to pumping though I'm sure others will disagree.

    ~Nancy~
    Homeschooling our way through high school, learning with them!
    19 year old son diagnosed T1 2/5/10, pumping Tslim beginning 7/13 ; Dexcom on occasion. Animas Ping 10/10-7/13. College student August 2013.
    16 year old daughter teaching her mom all about patience and grace
    .

  8. #8
    Join Date
    Oct 2006
    Location
    Maine
    Posts
    9,618

    Default

    Quote Originally Posted by nanhsot View Post
    Insurance dictated it for us, 6 months, and it was right at 9 months when we were pumping. I personally believe that it's a good idea to be skilled at MDI before going to pumping though I'm sure others will disagree.
    This was us - however, I don't think being skilled at MDI is any more important then learning the pump. There are quite a few people who get to start Pumping day 1 - mostly adults and some of the folks in European nations, if this boards history is any indication.

    I would search the topic here - it has been well discussed over the years.
    I'm still here.
    DD - 15 - Lantus and MM Pump/Dex G4

  9. #9

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    Quote Originally Posted by Lee View Post
    This was us - however, I don't think being skilled at MDI is any more important then learning the pump. There are quite a few people who get to start Pumping day 1 - mostly adults and some of the folks in European nations, if this boards history is any indication.

    I would search the topic here - it has been well discussed over the years.
    Honestly I think if we were put on the pump in the hospital it would be no more daunting than doing MDI, everything was being thrown at us anyway and our head was spinning. It's what you are taught, you learn it. My kid was so traumatized by the whole experience that doing a set might have actually been a bit easier than the shots.
    Diagnosed June '05
    Pumping since Feb '06
    Animas Ping
    Dexcom Study







    My current position:
    CIO...CHIEF INSULIN OFFICER

    "Life is under no obligation to give us what we expect"...Margaret Mitchell

    "Make it work"...Tim Gunn

  10. #10
    Join Date
    Jul 2009
    Location
    Northern NJ
    Posts
    1,721

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    I've heard lots of reasons but I honestly haven't heard a good reason ever. It may be great for a particular family or you may be glad you waited and yes it is a lot to learn, but the pump is basically an insulin delivery system, like a shot or a pen. You will be dealing with this FOREVER. Believe me, you'll have plenty of time to learn everything you need to know--until the next pump/cgm/meter/new insulin comes out. Then you relearn it. If some ppl want to put off pumping until they are more comfy or if they aren't tech savvy then fine. But there is no reason for a doc to have a rule that everybody should wait 6 to 12 months.
    Denise,
    DD age 10, dx at 4 (Oct 2006), Pumping with pink MM since July 2009, added Guardian February 2010. Podding over the summer since July 2012. Dex 4G January 2013. Also peanut allergic and asthmatic.
    DS age 13, non-D, but peanut allergic and asthamtic too. Also Asperger's, ADHD, and a pinch of OCD.

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