Diabetic 4 Year Old - Insulin Injections vs Insulin Pump

Hello E., Welcome to the world of diabetes! Our daughter was diagnosed with type 1 when she was 12 and is 25 now. Its not going to be the easiest world for these girls but it isnt impossible to carry on a normal healthy life. We think very highly of the insulin pump our daughter had. It was the only thing that stabilized her blood sugar and made her feel better. She was a brittle diabetic and several Drs felt she should get her BS(in more ways than 1) under control and then get a pump but it proved to be the other way around for her. The pump was so easy for her to learn and she was in the best control within a couple days of starting it. She was much older than your girl but they have ways to teach very young kids how to use them and how to keep them locked and protected from other curious hands and mistakes. Its highly recommended to give lessons on its use and how it works to any teacher and daycare provider she has so when you arent there it is being handled by someone with a bit of knowledge. Our first pump lasted 4 years and then started to malfunction and was replaced under our medical insurance. She had it for nearly 2 years and in a crazy mix up at a friends house it was lost. Insurance wouldnt cover another for 2 more years and the cost is pretty high.(up to $7000) At that time she was over 18 and we couldnt include her on our insurance anylonger so she has gone back to multiple daily shots. She wants another pump but is on her own now and just cant afford it. I want to tell you how lucky you are to have your girl diagnosed at the age she was. Not that Id ever wish diabetes on anyone at any age but at 3-4 you are still very much in control of her life, food, and schedule which makes teaching her how to care for herself much easier. She will grow up with her diabetic care so much a part of normal living it will be easy for her to do things right. At 12 we had started to "let her go" and become more independant and suddenly tried to pull her back and take care of things for her and it proved to be nearly impossible. She has such a mind of her own and wanted us to leave her alone and handle everything on her own. It was very difficult to sit back and watch and she did make a lot of mistakes. As parents this is by far the hardest thing we ever had to go thru but we have come out on a bright side with the birth of her baby girl last year. YES! A baby, healthy and adorable and showing no signs of diabetes at this point. It is a gift to have them both healthy and happy. You will have ups and downs, but in our opinion the insulin pump is wonderful and with the right training and care Id say even a 4 yr old will do very well with one. Check around different manufactures to find one whos batteries last a long time. Our first one could go for a couple months on 2 tiny batteries but the second pump would last a week and it was a real pain to be buying new batteries all the time. Also they can be covered under most insurances so the cost doesnt eat you up everytime you have to replace them. I know this is a long letter but gosh, this diabetes is a huge part of our lives and I know what you are going thru and would give you and that little girl a big hug if i could! Best of luck, and go ahead and try a pump and you may really see the benifits as we did. Feel free to email me anytime. (o:

I wish I could have an insulin pump! Ok, this might not be of too much help since I am not 4, nor have I ever had a pump...but I wish I could get one. The pros are: not having to give her injections all day long (and they DO take time out of your day to day activities). Also, sometimes my injections DO hurt, so she'd be saving herself pain. Also, though she should be eating on a pretty good schedule (meals every 4 hours, snacks every 2), it would allow her a little flexibility in her eating times. The biggest pro, that I can see, is that the pump is supposed to keep track of how much insulin you need throughout the day. No guessing. And because it pumps out what you need, there is less likely of a "low sugar" attack. Oh, and don't forget you won't have to deal with storing a ton of needles.
Ok, so the biggest CON that I can see (especially for somebody that age) is that she might have to be extra careful about running around.
The people I know that have used pumps prefer them far more than the injections, but I would suggest to keep asking around. Maybe find a clinic near you and take her to "interview" a few diabetics using these devices and have her help you make the decision.
Again, I don't know how a 4 year old would deal with a pump, but then again, I don't know how they would deal with injections either! The more injections she needs during the day, the more a pump sounds like the logical way to go. Maybe an endocrinologist can show you how big the pumps are so you can get an idea of how much they may or may not get in the way while she is playing? just ideas...

Thanks, and good luck! :)
S.

A good friend of mine has a daughter who has had type 1 diabetes diagnosed at 2 years old. She is now six and still using injections. Her mother wants her to eventually go to a pump but only after she feels her daughter understands her diabetes well. She wants her to know and be able to say that she's low or high (in case of pump malfunction). This little girl has been checking her own blood sugar since she was four, its quite amazing, she has to have four shots a day. Best of luck

Hi E.,

I helped raise my niece and she was diagnosed with diabetes at the age of six. She didn't get a pump until she was in her teens because of the responsibility that goes along with a pump.

I think 4 years old is way too young. All of the responsibility would definitely be on your shoulders. It is quite tricky to get the needle in correctly. If you don't or if she accidentally hits the site and dislodges the needle without knowing it (which is easy to do), then she won't be getting her basal dosage for however long until you check her blood sugar to notice. So she could be high for some time. This will especially be a problem if she is very active and likes sports or swimming. You'll have to check and change the site a lot more often. You'll have to check her blood sugar a lot more often also.

You have to keep the site very clean and be sure to change it regularly or she'll get an infection. You also have to check the pump often to be sure it is full of insulin. That was a problem with my niece that was a constant battle. It seemed like it always liked to run out in the middle of the night so she would be high in the morning.

Then there are little things like she won't be able to wear dresses. The site leaves more noticeable scars. It is more visible to friends so be prepared for personal questions about it.

When she starts school you will need support from the school nurse and her teachers. You will need that anyway even if she doesn't have a pump. But teaching them about the pump will help her manage throughout the day.

There are pros. There is definitely more freedom and only one poke every three days instead of four or more per day. It helped her blood sugars stablize more easily. But I honestly don't think it would have worked before she was older and was able to monitor it on her own.

It's my humble opinion that you should wait until she is old enough to really understand how to treat the pump and the consequences of mistreating it.

I hope this helps. Good luck!
Annie

I've been an insulin-dependent diabetic since I was a year old. Giving 3 - 4 insulin injections every day is a pain to do. Plus I was testing my blood sugars 3 - 6 times everyday because I am extremely insulin sensitive and my doses were causing my blood sugars to go extremely low. The insulin pump saved me from those multiple insulin injections (a minimum of 3 a day). Now I only have to change the needle that delivers the insulin once every 3 days. One needle every three days. Instead of a minimum of 9 injections a day. Plus as she gets older she can start doing this for herself instead of relying on you and her father to do this for her. I went to Camp Chinook/Camp Conrad for the first time when I was 6-years old, and at camp I learned how to give my own insulin injections, and I've been doing it ever since. My mom freaked the first time I did it and showed her. I showed her my bg level, my calculation for my insulin units, and then I gave my shot. After that I did it all on my own, and, of course, they double checked my numbers to make sure I didn't give too much or too little.

I have an almost 4 year old daughter who was diagnosed just over 2 years ago with diabetes. We had the same issues and concerns from our endocrinologist (I wonder if we have the same one). We did a lot of research and really did the gut check on how comfortable she would be with it and how much attention did we really want to draw to her attachment. In the end, we decided that we have good control, she's great with her injections and she takes gymnastics and swimming lessons and the pump is just not something that fits in her lifestyle right now. I hope this helps - if you want to talk further, please respond. Good luck to you and your little girl!

If I were you I would look in to Stem Cells for your daughter... we have seen many diabetics recover totally!!!
Love, G.. :0)
http://stemcellforautism.blogspot.com/

Hi, E.,
Hopefully your doctor has hooked you up with a diabetes center to help you understand how the disease works. They will know all the pros and cons and day-to-day issues better than even you can anticipate, and should help you decide which way is best for insulin delivery. The decision you make today, though, may not be optimal in two or three years, so you will want to revisit the pump/injection debate as your daughter grows and spends more time away from you. A center will also be very knowledgeable about how to get the best coverage from your insurer for any diabetic supplies. Good luck!

Hello!
Our 3-year-old son has had diabetes for 1 1/2 years also. We started on the pump about a month ago and love it. It's been so convenient, does all the calculations for you, can give a more precise measurement of insulin, and our son likes getting 1 poke every 3 days instead of 4 pokes per day. If you haven't already, you should join the Brave Buddies Yahoo group (for parents of kids with type 1.) That's a great source of advice also. Let me know if you have any questions!
A.

I know a girl that had erratic glucose levels with much trouble keeping it in check with injections. She got an insulin pump and pretty much got her life back. No worries and she feels great. Since your daughter won't be with you at all times to closely monitor her you should get one so you know she will be ok in your absence at school or out plating. I believe it will eliminate alot of stress on both of you.

Hi Evyonne,
I was going to respond with my husband's positive story about switching to the pump, but it sounds like you already have plenty of those!

Several women posted they thought it would be hard for a 4 year old to wear a pump and I wanted to give a suggestion to that: a friend of mine whose daughter was diagnosed at age 1 and began wearing a pump at 2 1/2, sewed pockets into ALL of her daughter's clothes. This way, it was out of the way for playing, other kids' hands, and provided eays access to caretakers/parents to administer insulin.

All in all, my husband took MUCH convincing to switch to the pump; he's very stubborn about going to the Dr since he feels they don't empathize with him (and many cannot possibly know what a diabetic goes through). However, he now says it was one of the best decisions he's made in his life.

Good luck and please know we'll be praying for you. It must be very hard to watch your daughter go through the ups and downs of a diabetic's life.

-S.

My daughter was diagnosed at the age of 3 she took injections for 1 1/2 years. It still took some adjusting but after we saw how it worked it is wonderful the freedom you have if they don't want to eat or if they want a special treat. My daughters A1C average has been below 7 for the last two years. I recommend it absolutely. It will not change the fact that they still don't have lows or highs but they are easier to control with out the injections. If your child does not mind the injections and you are keeping good control of the numbers then you are fine not to change but if not you can make adjustments easier with out all the injections. When your daughter starts school it will be a lot easier as well to treat the highs and by then if you do this now she will be used to having it and if like my daughter will know how to run it herself so it was easier for her to not have to take time to go to the office during class to put in the numbers. Her teacher looked over her readings and told her the carb count and watched her put it in. There was no time lost and she had her full lunch time with the other children. I do still recommend the continual testing through out the day. Good luck to you and your family I hope this helps

I am an adult pump user (7 years) and when I switched to Kaiser and my new PCP tried to talk me into going back on shots (I didn't "need" a pump according to her) I told her over my cold dead body. I've never had a seizure, never had a low so bad that I couldn't just treat it with OJ and be OK in 4 minutes, never been in DKA.

On the down side, pumps are more expensive than shots. About $2400 per year for supplies (YMMV), and your insulin will be more too because of all the insulin unfortunately wasted in the tubing. Some insurers cover supplies as DME, so if you have crappy DME coverage, that could be a factor. Another kinda scary thing is an article that just came out saying teenagers were at a higher risk of death when using insulin pumps (http://diabetes.about.com/b/2008/05/05/teens-at-risk-for-...)

You will also need excellent compliance at school (a well written 504 plan is a MUST) to handle boluses, equipment malfunctions, testing, etc. while your child is at school.

So, it is not a decision to be made lightly. However, it would be one that I would make for my child knowing how my quality of life and control has improved on the pump over shots.

Best of luck !

S.

The 8 year old I mentioned in my profile is not only Diabetic she is brittle. She has been on the pump for about 2 years now. I love it.
We would have to give her 2 shots in the morning, 1 at noon, and 2 at night. Her poor little arms would get so sore, she was just three when the doctors found she was diabetic.
At first, yes it was a new thing to learn but now the only shots she has to get is when she is too high. Her site is changed ever three days and yes, at first we had to hold her down to change the pump, now she can do it herself. We are no longer ruled by living on exact times for her meals. We have a little more freedom.
I would go with the pump anytime over the injections.
How is the family adjusting to her being diabetic?
My heart hurts for you. Keep the faith.
How close to the Lake are you? Is there a good support group there for type 1?

Dear E.,
I personally know a child whose life was changed for the better by getting his insulin pump.
He was just a little guy, and it just changed the whole situation for the better. He is 23 now, still has his pump and he's doing great. The pump actually freed him up from so many things about the regimen of the shots, etc.
All kids are different, but I'm guessing that your doctor recommended it for a reason.
It just may be the best thing that ever happened for your daughter.
Diabetes is tough on the whole family. But you can adjust. I know that that the pump was a God-send for my friend's son.

Best wishes and blessings!

Hi! I have a very good adult friend with type 1 diabetes, she uses the pump and what she said was; the overall control with a pump is better, but the highs and lows can be worse. Really good communication would be essential, if your four year old can clearly communicate any slightly "off feelings" this might be great. Certainly long term it is a better solution for insulin dependant people, but four may be a little young. You know your girl better than anyone. Please also check out Dogs for Diabetics in Concord. This organization supplies hypoglycemic alert dogs, a specialized type of medical alert dogs. If you had a dog, the pump would be a great option because her dog would tell you anytime she was going low. Go to www.dogs4diabetics.com, say that Cody sent you! If you have any other questions please feel free to call me at ###-###-####. Take care!
-K.

Hello E.,

In regards to the insulin pump there really is not much difference if you, as the parent, will continue to keep the childs diabetes under control. My husband is a juvenile diabetic and has been on insulin since he was 4 yrs. old. Actually, we were just in the doctor's office a couple of days ago and my husband asked the doctor that very question. She stated that as long as he kept his sugar levels under control with insulin injections that there would be no real need for the pump. Also, since your child is only 4, I'm sure she is active and a pump would just get in the way. There is no big advantage to the insulin pump right now maybe when they advance it. Good luck!

Hi E.,

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If you live in the bay area and would like to learn more feel free to email me or call ###-###-####
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Wishing you a healthy life for you and your family.

N. Marie