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Pump at DX...thoughts?

Discussion in 'Parents of Children with Type 1' started by MamaChrissa, Feb 11, 2010.

  1. MamaChrissa

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    I was wondering what everyone else thinks about giving someone, anyone, dx'ed w/ T1 a pump at the time of diagnosis. :cwds:
     
  2. hawkeyegirl

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    I think it might have been overload for us, but if a patient wants one, sure. If my other child was to be diagnosed, I would order one immediately.
     
  3. StillMamamia

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    We got the pump soon after dx (about 2 days in, while hospitalized).

    I would have preferred starting on MDI, just to get some structure in, kwim? I think going on the pump right away kinda messed up our understanding of how insulin works and when. If that makes any sense...

    Plus the whole thought of having something attached to your kid was daunting at first. Site changes were pretty stressful, but I guess that could be at any time.

    On the other hand, it allowed for flexibility, which, for a 2yr old, was really handy.
     
  4. melissajm

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    When Ben was dx'd he was on the pump within a month, but we all understood MDI, carb counting, etc already. I do think that the pump would have been very helpful when Lil was dx'd at 23 months, but at the same time I am glad we got all the training about insulin & how it works before the pump.
     
  5. Flutterby

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    I think the ONLY problem with starting with a pump AT diagnosis is the fact that you really do need to know how to draw up insulin in a syringe, or use a insulin pen, and how to calculate insulin dosages and corrections. If you started on the pump, and had a failure or something, you'd really need to know how to do these things as a back up.:)
     
  6. sarahspins

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    Exactly this.. I don't think it should be required, but it should NOT be discouraged either of the patient/caretaker wants it. It's important to know how insulin works, but I don't think that a pump necessarily prevents that from happening... it's just a bit different. I think any kind of comprehensive D education should cover all methods of injection, not just whatever the patient happens to be using.

    Anyways, I think pumping makes some things possible that super low doses on MDI really can't accommodate.
     
  7. joy orz

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    Our endo would like to see patients given pumps at diagnosis. I fought it tooth and nail for a year, but I think if they said "you can do this pump or these shots" we might have given it a go at the hospital.

    If we have another child diagnosed, I'd want the pump right away, and I'd recommend it to any friends.

    That said, pumps do malfunction, so it's also really important to have a handle on how shots work just in case.
     
  8. frizzyrazzy

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    we were given the option but we also were not given a good idea of what a pump WAS...so had I known, we would have done it. I think you need to learn "something" anyway - learning how to physically use a pump is really not a big deal - the diabetes learning is what you need and that would include shots/ calculating dosing etc.
     
  9. Brandi's mom

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    I dont think I would have wanted to go on the pump right at diagnosis.

    But now that we are 3 months in. I want her on one BAD and she wants it too.

    But our endo wont even consider it until 8 months to a year after diagnosis.

    The CDE actually told us we could talk to the endo about the possibility at our March appointment, then in June we could probably go to one of the initial appointments to learn about the different pumps and that we MIGHT be able to get her on it by next school year.

    I feel like I want to PUSH them to do it sooner, because alot of stuff is going to happen this summer, Brandi turns 16, wants to get a job, start driving, she's going to be allowed to date.

    Plus next year are the PSATs and the exit level TAKS (standardized test) and thats a big stressor for her.
     
  10. TripleThreat

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    Two here started pumps on day of diagnosis. I think it is great, i have prolonged their honeymoons and preserved bata cells. I wouldn't do it any other way, on CGMS as well
     
  11. Sarah Maddie's Mom

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    For us, I think it would have been a bit traumatic to see Maddie on a pump at dx. Emotionally it would have been a more difficult transition.

    I just need to say that I think it's a bit thoughtless to declare that because you got your kids on a pump right away you know that you preserved beta cells and thereby have done a "better" job than a parent who wasn't able to make that choice for whatever reason. Jmho
     
  12. C6H12O6

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    That is so interesting. Is this a common approach in Luxembourg?
     
  13. Mikker

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    I have no idea what our endo's thoughts are on pumps, but it really kind of chaffs me that some endo's have those type of blanket rules (be it 6, 8, 12, or 18 months). The decision should be made on an individual basis.

    I know that at our endo office, they really hate to make any type of changes at all even with a simple prescription. The paperwork is too big of a bother. I can't help but wonder if blanket rules like that aren't influenced a bit by how many office visits they've been able to charge, and try to ensure you'll be a long term patient before it's worth it for them to shell out the time it takes to try to get a pump approved. kwim?

    I'm one that thinks it's good to have a good handle on MDI, before pumping, but if J wanted a pump even a month after dx, and our endo told us we had to wait for 6 months... I would switch endo's. :D
     
  14. bgallini

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    I think it should be an option at least to go on the pump at dx or shortly after (ie w/in the first month.) In any case, I think we should have been given much more education on D care in general and about all the various insulin regimes and technology out there.
     
  15. TripleThreat

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    i didn't say it that way and im sorry you are looking at it in a negative way, and i never said that i have done a "better" job. I did not need training when they were diagnosed so they got the best care i could give them, their endo has told me that they have preserved bata cells because we started them on this regimen. I deal with 4 type 1s and this was my choice not the endos
     
  16. Lee

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    While I agree that starting the pump right away is a good thing and I wish we could have; I don't think there is any evidence of preserving beta cells...

    If you had good control on MDI, many don't even see a change in the A1C during a pump start. Therefore, that 1 simple fact discounts the theory that pumping prolongs the honeymoon.

    We had a VERY long honeymoon...it was strong for 2 years, and finally petered out at year 3...our endo had never seen one go on for so long and half that time, we were on MDI...
     
  17. liasmommy2000

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    It would have been way too much for us. But if a family can handle it and their doctor agrees then I don't see any reason why not. And I think those with infants and toddlers needing teensy doses would really benefit and perhaps be counseled on the benefits a bit more than the rest.

    We were told little to nothing about pumps at diagnosis. I think just what we read in the Pink Panther book they gave us. Heck, they didn't even tell us that there were other insulin options and put Lia on NPH and Regular! While I'm glad we were given NPH at the VERY beginning, I also wish they had told us that there were other options and as soon as she was comfortable with shots we could switch. Instead I had to read about it online and then fight for it. And I still don't see the purpose of putting her on Regular even then. I managed to get that switched at three months but it took six months to convince the endo to put her on Lantus.
     
  18. TripleThreat

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    right the only way to preserve is to have good numbers, The Endo does test the boys to see where their beta cells are every three months, and compares them to the group of children diagnosed at the same time. This is for a study to see if it is beneficial to start pumping at diagnosis, and this is where i get my information, the study deals with MDIs too so it is fair. I had good control in 2 of us before pumping, and it can be done that way, and i was just stating our experience with "pumping at diagnosis".
     
  19. wilf

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    I think you are off on a tangent here. It is possible to achieve excellent control on both pump or MDI, if both groups get the same amount of training.

    At our clinic families of children going on a pump get huge amounts of extra training (which really irritates me, because everyone would benefit from much of the training they are getting), so a comparison of pumping to MDI is not fair because in my view it's not the pump making the difference but the extra training.

    *****

    I think that in many cases there is a benefit to having a "boot camp" period on MDI before switching to a pump to learn the basics, but esp. for very young children a pump has got to make it easier to manage the D. In Germany where DD was diagnosed it was standard to put younger children on diluted insulin, which made dosing in smaller amounts much easier) but that is very uncommon here in North America.
     
  20. Sarah Maddie's Mom

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    Not negative, just insensitive.
     

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