Should I put my 4 year old on an insulin pump?

Just joined tudiabetes today!! :) I have a 4 year old boy diagnosed in Feb. 2012 with Type 1 diabetes. I'm considering putting him on a pump this summer. Any thoughts on why I should/shouldn't put him on a pump? We're looking at either the Medtronic Paradigm 523 or the Animas One Touch Ping. Any suggestions??? Also, we like to go swimming and boating in the summer a lot, do you foresee many problems with this while using the pump?

hi Mom, welcome to the community! Have you joined this Group yet?

http://www.tudiabetes.org/group/parentsofkidswithtype1

Please do. Our admin Lorraine's son was dx at 4 also, and I'm pretty sure Caleb went on the pump not too far after. glad you've joined us!

I would go with a yes to the MM but other's here may have different opinions on the pumps but PLEASE start pumping as soon as u can it realkly helped me with control.

Yes u do have a bit of trouble with the MM and water. The instrutions are to never get it wet or sumurge it in water don't know about the other though.

Short answer: Yes. The pump is not a cure, but it is a much more efficient and precise way of delivering insulin. I'm a T1, use a pump, and love it. If I had a T1 child, I would not hesitate for a second in starting him/her on a pump. I've met quite a few young children over the years who have pumps. A few things to consider regarding the different models:

  • There are three models in the US: Omnipod (tubeless), Minimed Revel, and Animas Ping. I personally would NOT use the Omnipod on a small child, but that is ultimately your decision. There seem to be a lot of issues with the Omnipod and the smallest dosing increment is 0.05, whereas the Revel and Ping can deliver doses as small as 0.025. Sounds insignificant, but in a small child, it can make a difference! Finally, when the Omnipod malfunctions, you can end up wasting a lot of insulin and stuff, and this can get expensive when Pods fail.
  • The Revel is water resistant and the Ping is waterproof. HOWEVER, as I was told by pump trainers and my endo, these are electronic devices and, to play it safe, they should NEVER really be submerged in water. I have gotten my revel wet a few times and it is fine. HOWEVER, any of the pumps can develop small cracks that can let water in and ruin it. Play it safe and if you're around water, keep it in a waterproof case (they make lots of these for iPods and cell phones and they can be adapted to accommodate a pump). I've also heard folks have issues with the Omnipod staying on in water.
  • Comfort is a huge factor for a small child. I tried one of the Omnipod pods and found that it was larger than I expected and it really bothered me in clothes (I'm a petite woman, about 5 feet tall) and when sleeping. The infusion sets used by the Revel and Ping are both very flat and unnoticeable under clothing.
  • Tubing: you get used to it. It really doesn't bother me. I am very active and you just get used to it. I usually keep my pump in a spibelt when exercising. It is not noticeable under my clothes.
  • The revel comes in two sizes - one that holds 180 units of insulin and another that holds 300 units of insulin. The Ping only comes in one size (one that holds 200 units of insulin). Granted, you never have to fill a reservoir completely, but it's nice to have the option to get the smaller pump (I have a relatively low TDD, so I use the smaller Revel, and I know a lot of kids opt for the Revel for this reason).
  • The screen on the Ping is AWESOME. The revel's screen is tiny and a bit hard to read.
  • In terms of durability, I'm about as hard on my stuff as your average 4 year-old boy. The revel has thus far withstood my abuse. But these are electronic devices and they will malfunction sometimes, especially if subjected to a lot of abuse.
  • I love the fact that you can get customized skins for the Revel (thousands of options available at Skinit.com). Small detail, but for a kid or an adult this can be something that makes it feel way more personal and way less clinical.
  • Minimed's Revel has the integrated CGM. I don't use the CGM on a regular basis, but if that's something you're thinking about using, having an all-in-one device is important for a small child. Less stuff to carry around, keep track of, and lose. That said, the CGMs take up valuable real estate and if you want your son to be able to pump for years to come, you need to be careful about the development of scar tissue. I try to save my sites for pumping, because for me that's more important. But sometimes I do slap on a sensor just to see how I'm trending.
  • The Ping requires a few more button-pushes than does the Revel.
  • Minimed's Carelink software is really good and easy to use.

All in all, if it was my child, I'd probably go with the Revel, primarily because of the slightly smaller size, Carelink software, reliability, and integrated CGM capability.

If you have concerns about your son wearing it (i.e., will he keep it in? Will he withstand site changes?) get hooked up with your local rep and ask them to loan you a pump to use with saline. It's a great way to practice and see if he will tolerate all this.

There is a HUGE learning curve with pumping. Read the book Pumping Insulin NOW. Be familiar with the terminology, how to set/adjust basals, etc. If you're able to get the pump, play with it. A lot. Practice with your son bolusing, setting temp basals, etc.

And remember that pumping is NOT permanent. At any time, you can stop using the pump and switch back to MDI.

Hi Cody's Mom, welcome to the Tu family! As I always say to the parents here, I admire you guys so much for all that you do for your kids. I'm Type 1 but wasn't diagnosed until I was 27 so I didn't have to deal with all this during those early years. One day Cody is really going to appreciate all that you're doing to keep him healthy.

As far as pumps go, I'm currently on the OmniPod and love it. There are parents on Tu who have small children currently on OmniPod so hopefully they will chime in.

After 25 years, I finally switched from injections to a pump and I wish I had done it long ago. For me, the learning curve with a pump was not as big a deal I think because I already knew the mechanics of carb counting and insulin.

Since Caleb was just diagnosed a few months ago, you may want to make sure you read and learn as much as you can about pumping and insulin activity. Learning the diabetes part and the pumping part all at once creates a bigger learning curve.

I think there are many pros to going to the OmniPod for an adult or a child. With the OmniPod there is no tubing to deal with. That was huge for me. I don't want to have to get used to manipulating tubing when I'm sleeping or under my clothes. The OmniPod helps me feel less like a PWD because I forget that I have it on and don't have to wear anything on my belt - more freedom. I actually will forget where I've placed the pod and have to "pat down" to find it.

I also like the fact that the OmniPod has an auto-insertion and priming process. You put the pod on and push a button on the remote pdm to insert the canula on the pod. It feels just like a rubber band popped you and you're set and ready to go. Super easy. You never see anything that looks like a needle.

With OmniPod, I can bathe or shower or swim and never stop basal delivery because I don't remove anything. I have had no problems with the adhesive on the pods from water; if anything, I have to pull hard to get the pods off.

I haven't had any pods malfunction and when I pull a pod early because of a potential site issue, OmniPod has always replaced those pods for me at no cost.

I would try the different pumps out and choose the one that suits Cody best. I've heard other parents say that they've worn saline filled trial pumps themselves to try out how they feel before they try it on their child so you may want to consider that as an option.

Definitely read and re-read the book Pumping Insulin by John Walsh. It's an easy read and written in an easy to understand manner.

Good luck and please keep posting and asking questions. You will find much love, support and encouragement here. :)

Thanks, I just joined the group. I love this website!! :)

Thanks for your help!

Thanks, I'm feeling pretty sure I want to pursue getting a pump, now I just have to decide which one!

Wow! Thanks for all the information!! It was very helpful!

Thanks for all the great information, I appreciate the time you took to help me out!

Heya Cody's Mom, welcome and just to say it, I am so sorry about your little one and you having to deal with T1 diabetes. Pumps look so huge on tiny people it always makes me sad. You sound totally positive and ready to rise to the challenge, though! I know you'll get any amount of help you need here.