To pump or not to pump...

We're just starting to consider whether or not to get a pump for our son. I've been reading anything I can get my hands on, but am looking for anyone else's perspective on this.

Our info: Christopher is 2, diagnosed 1/2009. His last 2 A1cs have been 7.9 and 8.4 (at diagnosis). We're currently using Lantus 3.5U/day, and then Novolog before meals. He is doing fine with the shots and finger sticks, and doesn't seem to mind them. He may be starting preschool next summer, as he is doing EI for speech right now.

We've been thinking that he might be better off if he has a pump before he heads off to school.

If we get a pump, any recommendations on a particular brand? It seems like the integrated CGMS would be a good idea too - are there any drawbacks to this?

Help!!!! I'm in information overload right now

 

We waited 2 years before we got Charlie on the pump. We just didn't think he would do well with having to wear it all the time. Also, I just don't think DH and I were ready to see it on him all the time.
Now that he is pumping we wish we had done it sooner. It has been wonderful. It has been really good for the entire family. One of the big pluses for us is being able to give him a little insulin before a meal and then give him the rest after the meal depending on how much he ate. We had always had to give him his shot after the meal because we never knew how much he would eat. Then he would get the spikes.
We use the Ping and love it. I love the remote.

 

Pumping has been a lifesaver for us. Jack is so much happier, we're so much happier, his control is better...no drawbacks for us.

We have the Medtronic pump with integrated CGM, and love it. I just couldn't ask my little guy to carry around two seperate units. And little ones move around so fast...you can't be chasing after them with a receiver all the time. The other advantage to integration is that your pump info and CGM info all appear in the same reports. Very, very useful.

 

I will be watching this thread closely. I also have a newly diagnosed 2yr old. We have been considering pump options, and believe that the accuracy of these units may be the best option for my son. We have another endo appt in about 3 months and plan on getting more information at that time. They gave us handouts a couple weeks ago, and of the ones they gave us the ping seems to appeal to us best. I hope to find more examples in the meantime of how well a 2yr old tolerates a pump attached to them.

 

My daughter was dxd just a week after her 3rd birthday and then started pumping within the first 2 mths. I am SOOOOOO glad we went with pumping then and have never regretted our decision. I was concerned about her messing with the pump, but it was really never an issue. I explained that it gave her the insulin she needed and if she played with or removed it, we'd have to go back to shots again.
We chose Cozmo pump (which is no longer an option) so I can't really give any advice on which one to choose. They all have pros and cons and you just need to decide which features are more important to you. I believe the Animas Ping offers the smallest basal increments (.025 vs .05) which is often nice for younger kids. It can also be controlled by remote... nice so you don't have to keep digging it out of their pocket/pouch. I honestly don't know much about Minimed. We're considering switching to OmniPod, but some people say it's too big for a child that young. All a matter of opinion

As to an intergrated CGMS, I actually specifically wanted something that was NOT integrated into her pump. I didn't want to have to be pulling her pump out everytime I wanted to see her BG. That would cause more interruptions to her play. Shealyn just started the Navigator this week and we're loving it. It has a 10 ft range (although it's larger in our house and can reach her just about everywhere) so I just keep it in my pocket or on a shelf. However, the transmitter is larger and I don't know if I'd put it on a 2 yr old.

Good luck! I would definitely encourage you to pump. In some ways, I think it's easier when they are younger as you still have more 'control' over them and they don't fight back as much. *laugh*

 

My daughter was older with her dx. She was nine. We are almost 2-1/2 years into this and doing MDI. At this point, she does not want the pump and I am not going to push her. We are entering puberty and are working closely with the Endo with her doses. Her last A1C was 9.5 after being 9.4 for over 6 months and 17.8 at dx. The lowest A1C was 7.8 after dx, however puberty has been kick and making D a pain in the rear.

I have heard that starting the pump with the toddlers and infants early is a great way to get a better control of D.

As for now, I am leaving the decision for the pump up to Dorothy and her Endo. The Endo does not think that she is mature enough to handle the pump for now, as to where her control with certain situations and school fall. It would turn into a disaster for her at this point right now.

 

My 2 yr old grandson just started pumping in Feb, and it's been great for him. Smaller doses, easier corrrections, and no shots! They're using the Ping, and love the remote - no digging out the pump to bolus.

And as for the concerns most people have about messing with it, I'm sure it depends on the child, but Zane is as inquisitive as they come, but he doesn't touch the pump.

Good luck with your decision.

 

I guess all I can say, since I don't have a young child pumping, is that pumping will offer you greater flexibility. We love it and haven't looked back since starting.

As for choosing a pump, all you can really do is look at and play with each one and see which meets your needs. They are all really great!

 

My daughter was diagnosed at 2 and we were on the Lantus/Log regimen for 5 months. We then switched her to the pump so that we could be on a more flexible schedule with eating and dosing. Preschool was also a factor for us as she started a 2 months after we started pumping. It made things a little easier in terms of the school because they were more comfortable dosing via the pump with me on the phone. I think if I told them they were going to have to learn to give her injections, they would have been much more anxious. We love pumping and wouldn't go back. I believe that every family knows when and if they are ready and for some, it's sooner than others.

Try to pick the pump that fits your family's needs best. CGM's are awesome, but it's not the sole reason to select a pump. Plus, with partnerships and advancements in technology, more and more pumps will have this capability. Minimed currently has the ability to communicate. Dexcom and Animas are slated for a pairing in the first quarter of next year.

 

Sean was seven at dx, and we did MDI for just over a year. The main reason it took us that long to get on the pump was that Sean was resistant to wearing it.

Once we did go to the pump though, our control improved dramatically, and Sean would never go back to MDI. Another poster mentioned the ability to give part of the meal bolus prior to eating then "topping off" once you know how many carbs he'll finish. I think this is a HUGE advantage to pumping. It is so difficult to pre-bolus with a young child, but for most diabetics it's so much better to do so, and the pump makes it easier to get there.

We chose the MM mainly based on the integrated CGM, which we credit equally for our improved control. Some people seem to think the Dexcom is more accurate, but I couldn't imagine having Sean carry the pump and a separate receiver and he's 10. If he was 2 I wouldn't even consider it.

Dexcom will be integrated with the Animas pump some time in the future, but no one will say when. The same goes for the Omni-Pod, but we found the pod bulky and Sean didn't want anything to do with it.

The MM has room for improvement, but we've had great results and no regrets. I think it's the best thing available right now.

I'd suggest downloading the user guide for the MM, the Animas and the Dexcom, and read them all. You'll have a much better idea how they compare. Then get your hands on each and push the buttons yourself.

I would not rely too heavily on your endo to give you complete and objective advise on choosing a pump; find out who the reps are for the pump manufacturers and talk to each of the reps and let them tell you about their pump's strengths (which they will exaggerate) and the other pumps weaknesses (which they'll also exaggerate).

After you have some knowledge about the available hardware, have a conversation with your endo and get their advise, but don't leave the desision to them, you're the one who has to live with the pump.

 

Kaleb uses the PING and loves it. This is his first pump so has nothing to compare it to. It does not have the CGM as part of the pump, but he was happy with that. If the CGM is an important thing to have as part of the pump you will want to go with MM.

We also like the PING for the remote feature as well as the small basal amounts. Even though Kaleb is much older he is pretty insulin sensitve and he uses the .025 more than you would think a teenager would.

We just had to change his basal rate tonight and took advantage of the smaller amounts.

I really do not think you would be disppointed with whatever pump you choose.

Kaleb was against the pump in the beginning and now he would not trade it for the world.

 

we are also starting to look at the pump for our 3 1/2 year old. I am also wondering about the cgm's. If you can get a pump with the monitoring built in, why would you not want that? If people can shed some light on why you would choose it versus not, that would be great as well. Thanks

 

For anyone who will be using a pump and CGMS, you are right. The MM is a no brainer.

Animas now has a way cool remote/meter. It also has smaller increments on the basal rate (most beneficial for really little kids and others with high sensitivity), and you can more easily see the IOB.

Some people like the tublessness of the omnipod.

Anyone still using anything other than these three (or the cozmo)?

 

We started Emma on a pump 6 months after diagnosis - she went on the Animas. We recently upgraded to the Ping and we love being able to bolus from the meter / remote and not having to pull out the pump.

At this point, I don't want the integrated CGMS. With the Navigator, as Kaycee said, you can be across the house and usually get a reading (we easily get 20 feet). So, the receiver stays near me and I get the readings. The only time she "wears two" is if she's out on the playground and running around. I bought a pouch from "Angel Bear" that just slides on a belt. I slide it onto the back of her pump belt and she wears it in the small of her back - and just runs up to me if it beeps at her.

There are two reasons I didn't want the integrated:
- I didn't want to have to be pulling her pump out all the time to look at the readings. I'm enjoying now that I don't have to pull out the pump to bolus
- I like being able to turn over at night and push a button to see the readings. The other two non-integrated ones (Minimed Guardian and Dexcom) have only a 5 foot range so the furthest away they can be from the transmitter is 5 feet

But, the downside to having that kind of range is the size of the transmitter. It is large and I would definitely recommend you see it in person and hold it up to your child's arm. I think it would have been too big for Emma two years ago. Its still large now, but it fits. The Dexcom and Minimed transmitters are smaller - thus the shorter range.

Good luck - you can't go wrong choosing a pump

 

Luke was 27 months when he was diagnosed and he started pumping 3 months later. We would have had him pumping in the hospital if our insurance would have allowed it! We chose the Minimed pump because we hope to get the CGMS in the near future. Pumping has been so wonderful for us! It gives us so much more flexibility and we can have much tighter control than we could with MDI. It's definitely a personal choice, but most people that start pumping end up loving it.

 

Have you seen the size of the screen with the readout on the MM pump for the CGM? I'ts about the size of a dime. The Dexcom is easier on my old eyes; especially with an active toddler trying to run away. The insertion needle is also smaller (and its still not small).

Yossi started to pump 3 months after diagnosis; a month after his second birthday. We also love using the Animas Ping, although I don't use the remote very often. We use the Contour meter rather than the (blood sucking) One Touch built into it. We never had any concern about something being attached to him and how he would take it. When he gets dressed in the morning, he picks out his shirt and pump pouch for the day and we get him dressed. He wears it like any other piece of clothing he puts on. When he first started pumping, he got very upset when we detatched the pump from him for set changes or baths, so we let him bathe with it on. After a few weeks, he was more comfortable knowing that he would get it back right away, so didn't fuss about taking it off anymore.

 

The benefits to integration:

1. Your child only has to carry one unit. Big for us, because my son is young.

2. Your pump data is integrated with your CGM data. Also big for us, because looking at the CGM data is a bit worthless without knowing when you ate and bolused, when you ran a temp basal, etc.

3. We are dealing with one company, which I think somewhat simplifies ordering supplies and customer service. Not a huge deal, but still a benefit.

The drawbacks to integration:

1. You have to get the pump out to see a CGM reading. We use a clear front pouch, so I just lift up his shirt and glance at the reading.

Really, the ideal would be an integrated unit with a seperate receiver for a parent or caregiver to use. I'm sure that is coming (and indeed, MM will have a parent monitor for use around the house and at night in a year).

If integration was not considered important, all the pump companies would not be working furiously toward it. They will all likely be integrated with a CGM in the next year or so, and the vast majority of people will end up going with the CGM that is integrated with their pump.

 

Dylan has been pumping for just over a year, and I must say its the best thing we have ever done.

 

I couldn't agree more, and would emphasize number 2. I feel this is at least as important as the real time data and high/low alarms. The reports you pull from Carelink are what you will use to fine tune your insulin delivery, and they would be far less useful without all the info the pump stores about carbs and insulin (and to a lesser extent the manual logging of exercise, set changes, etc. you can add to Carlink).

If we stopped using the CGMS today, we would continue to reap the benefits of the data we collected in the first weeks of use.

 

you can do trials on them all yourself. try them on you and see which one will work on your child. try the sets for pump and the cgms.

I personally think the mm's needle cgms is too large for a small child. but i've never worn it, just seen it though. I think that its awesome in that you have cgms in the pump.

and they are returnable. we returned our first pump. wasn't in love with it.