My 2 year old daughter was diagnosed with Type I when she was 18 months. She is currently taking 4 injections a day and I am considering switching to a pump. I definitely want to try the pump but I am wondering if she is still too young. I am not sure how the pumps works but I am wondering if she will keep it on, if she will play with it and cause something to go wrong, if she will be uncomfortable sleeping with it, whether other kids will yank if off, or if she will she feel a stigma? Thank you.
My friends' daughter was dx'ed I think around 18 months and went right to a pump? Her mom is a veterinarian, which would perhaps be an advantage and her dad is one of the smartest people I've ever known. They never mentioned junior yanking it out or anything like that.
I think pumps are great tools for managing diabetes in young children, primarily because they allow for quick adjustments to basal rates and the delivery of VERY small doses. For a growing child, these characteristics can really result in better overall control. Pumps also give more flexibility, which I would think is important when dealing with a young child.
Pumps work by delivering small amounts of fast acting insulin at variable rates throughout the day (called the basal rate). These basal rates are determined by you and the endo, and they can be temporarily adjusted for things like increased activity levels or illness. In addition, each time your daughter would eat, you would deliver a "bolus" of insulin. The bolus is calculated by the pump after you put in your daughter's blood sugar level and the amount of carbs she's eating. The pump then calculates the amount of insulin needed based on that information.
If you are even considering starting your daughter on a pump, you should read Pumping Insulin (available on Amazon). It's the bible of insulin pumping. Read it a few times. In addition, there are some great videos on YouTube (just go to YouTube and search for "insulin pumps") that show people changing their infusion sets and operating their pumps). In fact, here is one of a parent operating their child's pump - http://www.youtube.com/watch?v=L1zs_LYOiB4.
Overall, the pumps are not that complicated. I think they can be overwhelming for some people, but my iPhone is way more complex. That said, pumps take a lot of attention and patience. The first 6 months can be a rollercoaster, and I think this can be even harder when dealing with a small child who cannot communicate how he/she feels.
As an adult, one benefit of pumping I've found is that my highs and lows are not as severe. I can usually catch them faster and correct them easier.
Most kids keep their pumps on just fine. Yes, infusion sets do get yanked out from time to time I'm sure, but it's pretty easy to stick a new one in. They also are stronger than I expected. The newer ones stay in very well. I use the Mio and with a little Skin Tac and some IV3000 film over the site, my site easily stays in for 4 days (and I'm about as active and rough as your average 2 year old).
I know the Minimed Revel (the pump I use and the one shown in the video I posted above) have a lock feature. You can lock the pump so that a child cannot accidentally deliver insulin.
As far as sleeping with it, I am really not bothered by it. You can get used to just about anything and that includes insulin pumps. Small children are even more adaptable. She may be bothered by it initially, but once it becomes a permanent fixture in her life, I am sure she will be fine. Many children also keep their pumps stashed in little pouches or Spibelts. There are quite a few that are specifically made just for pumps.
Do your research and start talking with your daughter's endo about beginning the process for getting a pump. You will likely have to take classes and do some one-on-one training, so get that done as soon as you can. Also, the process for pump approval can take some time, so be prepared for a little bit of a wait.
Most importantly, remember that the pump is not permanent. At any time you can take it off and go back to MDI. That said, I think most people like their pumps so much that they wouldn't dream of going back to MDI. I know I wouldn't!
Finally, really research which pump is best for your daughter. I have the Minimed Revel (it is the one shown in the video) and personally it would be the model I would pick if getting a pump for a small child.
NOTE: the new version of Pumping Insulin is due out in May or so. I would not encourage you to get the current, soon to be old version when a new one is about to come out. But do get it when it does. It will be version 6? Not sure if it will be 5 or 6 but you can check the dates on amazon.com.
I just checked online and the new Pumping Insulin will be edition 6. There is also a new edition of "Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin--Completely Revised and Updated by Gary Scheiner (Jan 24, 2012)" and that one is worth getting also.
My daughter is 3 and I've wanted to switch to a pump too. Here are a couple things my endo said to consider. Obviously, the toughest thing to master is pump training. Because I work, my daughter goes to daycare and will also be starting preschool in Sept. Since she is too young to work the pump, someone has to do it for her. It makes it harder when there are "so many cooks in the kitchen" ie having to train dayhome providers, grandparents, teachers/aides (if they would even be willing.) If I could stay at home then I think we'd have the green light. Also, he said because there is less surface area, sometimes rotating sites becomes an issue, esp if the child refuses to let you use certain sites, like tummy. I have researched different pumps, and given the chance I would choose omnipod because of the tubeless system. I think it would work for an active toddler. I'm gonna stick with MDI for another year or so but when she hits full day public school she qualifies for a trained aide, so I will be all over the pump then! I definately like the benifit of tiny doses that pens cannot provide. (I am sure you agree! 1/2u is just not precise enough)
Damn! I got think like a pancreas in december! Wish I'd have known