So my DS. my wife and I attended what I call the Pumps 101 class at CHOP. DS wants a pump and we are taking active steps to get it, but I was, and remain, nervous about the pump.So I wanted to share what i am thinking/feeling. Regardless of my feelings, he is going to get the pump simply because he believes it will improve how he feels and manages T1D. Right now, he is tired of shots, and one set every three days is better than 7 jabs a day with a pen in his mind, and I fully realize that his experience/mindset/opinion matters far more than mine. My job is to get him to adulthood in as best shape possible spiritual/physical/emotional. So whatever that takes. Remember, prior to DS's diagnosis 20 months ago, we had no experience with T1D at all. Nobody on either side of the family ever had it. Also, at diagnosis time my DS was very very sick. So lets just say I have a healthy amount of respect for T1D and what it can do if trifled with. Remember also that our T1D journey started with an 11 year old, not an 11 month old. So I am living in a world where dosing to the unit or 1/2 unit is sufficiently accurate for the size of the person/problem. I dont need to worry about tenths of units or hundreths of units. I dont have to think about giving a shot to a 1 year old several times a day. So here are my reasons for hesitation/nervousness. 1) Change for no improvement. On MDi with a motivated/dedicated/smart kid, with the benefit of a CGM, and getting around the learning curve as fast as we could, we are having terrific success against T1D. At his last appointment his 90 day average glucose was 129. He was less than 50 less than 1% of the time. His A1C was 5.7. he has grown like six inches since diagnosis, is eating us out of house and home, and is at least 6 months into puberty. He is on 20 units of lantus and our TDD is north of 45 units most days. We are not going to get any better number s with the pump. In fact his numbers will get worse as we come up to speed on the pump. It took us a while to figure out MDI. We have to go through the learning curve again and hopefully be in the same position we are now. 2) I get the feeling that in 2 years the technology and standard of care are going to be radically different than today. he wants a tslim and its clear that we will be locked into that pump for 4 years regardless of what comes next. I am thinking about artificial/bionic pancreas technology. So if we switch now, we may lock ourselves out of better tech just down the road. I am guessing this is the first time in T1D history where this is actually a concern. 3) pump drama/trust. This set. that set. this site. that site. absorption issues. mecahnical issues. Life on MDI, for the caregiver, seems very simple compared to pumps. Keep the unused insulin in the fridge, have a box of pen needles available, rotate, count to 5 after an injection.....and the insulin is unquestionably in with no ifs ands or buts. I never have to ask myself "did that insulin go in?" I personally watch the lantus shot each night (after a year of administering it) because of how important it is. We have never, ever, missed a Lantus dose since diagnosis. We have never had more than slight ketones since diagnosis. 4) Numbers. Just because the pump allows you to adjust basals for every hour doesnt mean you can do that accurately or what you pick will be different tomorrow. Its bad enough the numbers swirling around in my head with the *simplification* that I can only set a basal once per day. 5) Site preservation: If he starts the pump now and starts using body locations, will sites become harder to find when he is 30 when the tech will presumably be better? Put another way, by using his body to host these sites today, will it preclude use of better tech tomorrow? So again, DS gets to pick. I will do whatever it takes to keep his head in the game and remain motivated, but these are the things on my mind. I am not looking to start an MDI vs pump flame war. These are just the things going through my 20 month into this diagnosis head. So I am off to pick DS up from theatre camp. The Share says 325. His basal needs to go up. thats with a zero carb breakfast (he had eggs in a rush out the door to get to camp), and DESPITE a unit as he started his day at 150. I can tell you one thing, whenever this pump starts, his basal numbers between 8am and 12 noon will be alot higher than those between 1am and 6am.