What is it like switching to the pump


my son is scheduled to switch to the pump in march so i was wondering what experiences people have had switching to the pump

what is the time period like for a transition

he is three years old and i am just wondering what i am facing - what could be ahead of us

he was diagnosed 10 months ago

and he was doing really well for a while - then i went back to work and he went into daycare and he hit a growth spurt and all hell has broken since

he has hit severe lows, extreme highs

and so i am just hoping at some point we'll all get a break

Hi there. My daughter is 2.5 and has been pumping since August. It is awesome and we love it. We have much better control and her A1C has dropped significantly. We no longer have tons of scary lows like we did when we were on MDI. Of course, in addition to pumping she started wearing the Dexcom CGM and that has been an enormous help.

Everyone’s experience is different, but we felt like switching to the pump was pretty seamless. We talked it up to her a lot in advance so she was expecting it. It took about 1-2 days of wearing the pump before she was used to it and didn’t seem to notice it anymore. We did our homework and watched a lot of YouTube videos and such before we started so we had a good idea of what to expect. It took a few weeks to get all her settings dialed in but, all in all, it was very smooth.

A big part of what made our transition so easy was the CGM. It enabled us to see the effect of what we were doing right away and gave us back sleep at night because we knew it would alarm before things got too out of hand. If you haven’t considered it, I really recommend that you do. Especially with the very young ones who grow so much so quickly and eat so unpredictably, I can’t overstate the value of it.

Best of luck!

My 4 year old was diagnosed a year ago and he switched to the pump AUG 24/2010. We just went to disneyland and I could never have gone without the pump.

It is really tough switching to the pump and I wrote about the frustrations on my Facebook Group “Canadian Diabetes Type I” under the discussion, to pump or not to pump.

I had been told it is a 3 month HUGE learning curve. We are at 10 weeks and the kinks are still not ironed out.

His Dawn Phenomenon continues to mystify me as it is not consistant. How can he be “7” at 6am and then go to “15” at 8am? Then the next morning he will be fine? (Sorry, I have Canadian numbers and don’t know how to convert)

Also, I have to figure out two different programs altogether for basal and insulin to carb ratios because Payton is SUPER sensitive to insulin with a brand new site and SUPER resistant to insulin when the site is nearing 48 hours old. I am currently making a DAY 1 program and DAY 2 program.

Payton is so resistant to insulin in the morning that when he was on needles, he would almost have the same amount of short acting insulin as long acting insulin. Now that he has the pump, I see that his insulin to carb (I:C) ratio is 1:18 and his I:C ratio at night is 1:25.

Finding out all of these numbers to put into the pump is super frustrating. In the beginning, the first month things were looking pretty good. But then the progress stopped when we couldn’t fix the nighttime highs. We found out the peanut butter at bedtime snack we always gave him to carry him over the night without a low is now a NO NO. No more peanut butter at night because then you get into combo boluses and what not. Turns out the peanut butter affects the blood way past what your insulin can handle in the 4 hours.

Also, once I gave him JUST lasagna for lunch. That is a NO NO. He hit 20. If all of his food is digested in the very same way at the same time, the pump won’t help at all because ALL of the insulin peaks at the same time (unless you are an expert from the beginning and know to do the combo boluses for his body). There is no long acting insulin peaking at a different time to help with the high. SO if you don’t add yogurt and an orange in to vary when the food is digested, then you are out of luck.

I learned the combo boluses several weeks back but they don’t focus on that in the beginning so avoid high fat food until they teach you that. I am assuming you are going to have a team helping you learn the pump but I am not sure what support you have.

I was put on a strict meal plan with a certain number of carbs to stick to with no morning and afternoon snack for over a month so the food would be completely digested and they could see if he could go for 2 hours without going low (to figure out the daytime basal). Payton was SOOOO hungry. I had sugar free jello and meat and cheese for him. It was tough.

The infusion sets that he was using have a larger caliper than the needles he was on so those were no fun either. I switched right away to an infusion set that had the same caliper. I have the Animas pump so instead of Animas sets I bought Orbit micros which have a very tiny needle. Before these he would cry during the site changes and would be moody for hours. For 3 weeks now I have just been sneaking into his room and changing them at night. His bottom flinches and he is a litte bit awake but too tired to complain about it much. It has gotten to the point now that sometimes he doesn’t even wake up. What a relief. He used to wake up for an entire year at night when I poked his finger.

Payton is going to playschool again this year but this time I have to sit outside his door for the entire time. Last year I could just tell the teachers to make sure he ate all of his snack. This time I have to be there the entire time because his pump is unpredictable. Too bad we had to start the pump at the start of school instead of during the summer. It will be nice when his numbers are predictable again. The preschool teacher’s son’s friend was Type I and the friend used to sleep over so the teacher is used to poking fingers and watching for lows so eventually I will get my freedom back.

So far the pump tube disconnected itself TWO TIMES!. He hit 34! He was 36 when he was diagnosed. That was terrible. During this past Halloween 2010 we were at Disneyland trick or treating and it was loud so we didn’t hear the alarm to state there was a bubble in the tube and the pump had stopped. Yikes! The last time I had checked his pump was 1.5 hours earlier.

Okay, so that is mostly all of the bad stuff that no one tells you.

On the flip side, Disneyland with Diabetes was a breeze because he ate what he wanted as long as there was a variety. I got into trouble when he ate half a mickey soft pretzel at 50carbs but what is cool is that you can correct at any time. If you guessed the carbs wrong when you eat out, you can correct an hour later because your blood is not supposed to go up more than 3 points (or so) when you eat and the pump will tell you how much insulin you need to give to fix the current number.

I just could not even imagine the freedom that I actually have now. Technically, he should be able to be fine if he didn’t eat for a whole 7 hours because the basal insulin would match what the liver spits out. Of course the kid would be hungry but medically, he would be fine. So weird.

I do not like needles because the long acting insulin peaks at different times depending on where the site is, how much exercise that area of your body gets, how deep the needle went, if you used that spot for insulin before. etc. How can a person get any control that way.

With the pump you can get super control. It takes some investigation work though. It is like a game. Sometimes you figure it out, sometimes its trial and error learning to apply next time.

The hospital make me poke him at Midnight and 3am. I have not slept through the night yet but I am sure looking forward to it when this “second day site / Dawn Phenomenon” thing is worked out.

Having the pump is the closest thing to normal we have felt in a long time. Reminded me of first diagnosis though with all of the emotions you get. You are going to love it… when the learning curve is over. LOL!


My son was diagnosed in Feb 09 we have been pumping since April 2010 with the animas ping. It was hard for a while and we are still learning. The best thing I did was to order the book Pumping Insulin and read it thru before going on the pump and then again as we were learning the steps, I still refer to it often. The first few days he was low constantly I guess because his body was accepting the insulin so much better, so watch for this. There are a lot more variables than with shots and we are constantly adjusting. It is still hard, we still have highs and lows although when he is high we can start correcting immediately and we can start bolusing before he starts eating and make up the rest as I see how much he actually eats. His a1c has improved from 8 to 7. We had an episode a couple of days ago where his infusion set came out in the night, he woke up with a bg of almost 400 and large keetones this is only after we checked him at 2:00 am we always still do this. We had to give an injection and replace the infusion set it took a while for things to get back to “normal”. All in all we still prefer the pump to shots! Good luck!

Matilda… GBY and your son…
I’m a grandmother of a girl 2 years and 9 months old, diagnosed in july…almost the same age and time of your son…My grandchild lives with her parents(she is my daughter) in the states, while Iam far here in Puerto Rico. I travel as often as I can to spend time with them…
Last wednesday my grandchild started in the pum trial (Anima’s)…She has accepted it real good and although as for the trial time is giving her just saline water, she has been fine with it…My daughter read and learn a lot about diabetes since she was diagnosed, so Iam…and she has been talking to her girl about it before the pump trial begins…Is very important to be instructed so the wonderings are less… My grandchild and her parents have a very good and prepared specialist in diabetes whose has been able to give them advise and orientation in every aspect…ad is available through e-mail too. Is a great thing to know you have someone to trust in adittion…
I know is very dificult to be working out and let your child in others hands but if you need to do it, ask those persons to get in touch and learn averything concerning to your son and this condidtion…there are places very welll prepared in that. I’m not saying your daycare is not…understand me please…
But believe us when we say the pump seems to be the best alternative…it gives freedom to the child and although is still an awesome job the one that mommy have to do…in a way is a form of relax to…understand me?
Well we do everything we can and we are letting all we can not in God’s hands. He will let science find the cure …As for us we are willing to see a miracle in our princess…Again, God Bless You, give you peace and wisdom to do what you need to do…A big hug…Tita

I would like to know where to get the book Pumping Insulin…Doest it comes with the pump? Thanks for your help…GBY!

So here is an example of how wonderful the pump is.

In Canada we have a 24hr flu going around and last night Payton (4yrs) hit really high numbers. I checked for Ketones and there was just a bit. At first I thought it was the pizza Grandma bought him for supper the night before, but I used a combo bolus so I doubted that the pizza was the reason. (It was indeed the flu I later found out.)

I bolused what the ping said to and the next hour he was down only a smidge. He was supposed to be right on track. I checked to see if I could bolus him some more but the pump said there was enough insulin on board (IOB) and not to do anything. I poked him in another hour and he was up a smidge. This time I was really concerned. I bolused him more than the ping said to but then I don’t have a rule for sick days, really, since he has only been on the ping 10 weeks. He went down only a smidge in the next hour. So this time I increased his basal insulin by 50% and bolused again more than what the ping said to now that I have established how his body is reacting to insulin. He was within normal range the next hour and for the next 3 hours he stayed at the same number. I would have had to give him several needles last night to bring him down if I didn’t have the pump.

This morning I woke up before he did to correct him because that Dawn Phenomenon is not fixed yet and when he woke up his numbers were awesome. He was incredibly happy this morning and he even ate half of his breakfast and has been able to keep it down. I only gave him insulin a bit at a time to make sure he could eat what was in front of him. You wouldn’t want to do that with needles. I love the pump.

So when Payton started the pump, I found him a little friend his age that was already on the pump. He really looked forward to being able to eat at any time and as much as he wanted. Payton had a really positive outlook on getting the pump. I tried 3 infusion sets on myself first and read the book “Think like a Pancreas” and am attempting to get through the book “Pumping Insulin” but havn’t finished. The Animas rep gave me both books. Payton was on saline for one day then straight to insulin.

The first day or so he was on the low side because he still had long acting insulin in his body plus the pump only uses short acting insulin which your body uses more efficiently.

I think having a CGM with the Animas pump would be awesome. Can’t wait for Dexcom to have a deal with Animas up here in Canada.

I think if I had a CGM at start up, I would be sleeping through the night right now and not be dealing with the current blood number problems that I have now. Problem is, I won’t give up the Animas Ping. I need the small increments that Animas goes down to. Payton’s basal is .025/hr from noon to 5pm. He is really sensitive to insulin and I need the small numbers when I bolus him for meals too. Also, I needed to try out several sets to see which one payton would like. You can do that with Animas. Also the Ping is super super handy when the 4 of us are driving on vacation and the kids are eating in the car. I can bolus him from the front seat. I bolused him in disneyland while Grandma was pushing him in the stroller, I can bolus him when he is wearning snow pants or in the car seat. I would not like to have to dig into his spibelt everytime I need to give him a correction.

The pump is wonderful.

thank you so much for your response. i am from canada as well, ontario. our situations seem quite similar. my son is on a carb/insulin ratio right now to prepare us for the pump - and it was suppose to level him out but it hasnt. they have a feeling he is dealing with the dawn phenomenon and as well, a morning insulin resitance which makes everything difficult. so we are trying to get to a solution. which is just putting him with a thousand different scales.

i also have been having to check him at midnight and at 3am. so no one is sleeping on my end either.

i have been sick this past week so thankfully i have had my husband to help take over for a bit so i can try to get better.

i am looking forward to the pump and having him on it - its the huge learning curve i am not looking forward to.

he is in daycare right now
how long do you think he would have to stay home, or will he - after starting the pump

he will have it put in him with saline for a few days and then move into having insulin

this will all take place in march

was your daughter in daycare or home with you when she switched over?? is the CGM painful for your child?

I was told by several other people before starting the pump that it takes 3 months to set up the pump. If you have the CGM it could take a month I would think. I am on week 10 but unfortunately Payton caught croup for 2 weeks and then we were in Disneyland for 10 days so those numbers don’t count, thus adding to the whole set up time.

I must admit that it is extremely time consuming to fax in his numbers on the chart that they want and it is burning me out but the good thing is I have plently of time to do them as I sit in the hall of his Playschool for 2.5 hours MWF.

I suspect that by December I can leave him safely at school. It is taking about 3 months for me because I don’t have that CGM and you can only change one number every 3 days. If there is a lot to change then it can take quite a long time.

They have to set up the I:C ratio for Breakfast, Lunch, Supper and Bedtime snack first and they are conservative with the bedtime ratio until they trust that you can keep your own child safe.

The CGM needle for medtronic is stinking huge and my friend’s 4 yr old girl only wears it when she is extremely sick and when they were setting up the pump.

Incedently, I was able to try out any infusion set that I wanted by contacting Melanie at www.insulinpumps.ca. She sent out samples to my Safeway pharmacy for me to try. The people that work there are all on pumps or have children on pumps.

You really need to join “Canadian Diabetes Type I” on Facebook. They talk about a bunch of stuff Canadian related.

The toughest decision I had was which pump to pick. My friend and I compared our children’s pumps to eachother’s and she chose Medtronic for the CGM and I chose Animas for the Ping remote and the small increments. My guy is super active and super hard to figure out.

We’ll have to keep eachother in the loop to share what we learn. Are you on facebook?