Insulin Pumps - How to Handle Your Child's Transition

When a child transitions to an insulin pump, a parent may go through a myriad of emotions and mental setbacks. Learning to accept that a battery-powered device is literally keeping your child alive can be extremely difficult for a parent. Yet freedom of multiple injections as well as better health for their child makes the initial fears start to diminish.

There are many reasons why children are placed on pumps. Sometimes it is because of the activities they are in. They can monitor their blood glucose levels more accurately, avoiding extreme highs or lows. Unfortunately, the most common reason is because the child is not monitoring their blood glucose levels as well as they could, or are having trouble maintaining good levels.

An insulin pump is a device the size of a large pager, and is worn on the belt or pocket. The pump delivers both types of insulin. The insulin flows through very tiny tubing, which is attached to the abdomen by a tiny needle. The needle is inserted under the skin, and stays attached with a small adhesive patch. The needle is moved to a new site every 2-4 days.

The insulin pump will deliver a continual dosage of long-acting insulin, much like an I.V. drip. This rate can be preprogrammed based on the amount of activity during certain times of the day, such as football practice. In the beginning, the child's numbers may fluctuate a bit while the amounts are fine-tuned. Eventually, there will be less of the extreme readings and more of the normal readings.

A bolus is manually delivered, and is used for covering the meals or if needed to correct a high blood glucose reading. The child's blood glucose meter is synced with the insulin pump, and records the readings. These readings will help the insulin pump "figure out" how much of the fast-acting insulin should be administered at that time.

For children, no longer having to inject themselves multiple times a day is the most obvious advantage of the insulin pump. Instead, they only have to re-insert the catheter every few days. They still have to test themselves, especially two hours after meals, but this is a small price to pay compared to daily multiple injections. Insulin pumps have timers to help remind the child to test after meals.

The other major advantage of using an insulin pump is the controlling of blood sugar levels. Not having extreme highs and lows is better for the child. The better controlled the child's readings, the better their A1C results will become. Their long-term health will benefit from better control of their blood glucose levels.

For some parents, trusting a small device with their child's health is very difficult in the beginning. Having to "learn" how to care for their child all over again can sometimes cause the parent to have some mental flashbacks of the first time their child was diagnosed. This is more of a possibility if the time of the initial diagnosis was not that long before the switch to the pump. Also, watching their child insert the needle and catheter can also be difficult.

When their child was first diagnosed with diabetes, parents may have had trouble with not worrying about their child while they were sleeping. The feelings of fear that their child may have a high or low and not be aware can be a very scary feeling for a parent. Memories of these feelings can return while trying to learn to "trust" the pump. Mostly it is concern about the pump becoming disconnected or the tubing getting crimped. Once the parent sees that this won't happen, the anxiety will disappear.

A parent may also be concerned about physical activity while wearing the pump. The child can still participate in sports or go swimming. All that is required is disconnecting the pump and tubing. The downside to this is that the amount of time the child can be disconnected is roughly 1 ½ to 2 hours.

If a child was switched to the pump because of poor monitoring of their blood sugar, trying to get the child to test 2 hours after meals can sometimes be a challenge. The sooner they become more diligent with this, the sooner their numbers will improve and even out. Once the insulin levels are determined, the child can do less testing.

The biggest key to mentally accepting a child's switch to the pump is making sure questions are asked and fears are discussed with the nurse who is assigned to your child. Once a parent sees improvement of the A1C test results, relief over your child being in better health will replace the fears of their life being placed in the hands of a battery-operated device.