Your 10-year-old daughter simply returned from diabetes camp. She stated that everyone was using an insulin pump, and she wants one too. You are worried about having a tiny computer provide insulin into her body. Should you ask your daughter’s health-care team about pumps?
Your three-year-old boy is a very choosy eater and you are having a very hard time managing his blood sugar levels, even with numerous injections every day. You have found out about insulin pumps, however is he too young for one?
Your teen has actually been utilizing a pump for about three years. She is now on the cheerleading group and she does not like being connected to the pump since of how it looks on her clothing. Should she change back to injections?
These are all typical circumstances for parents of children or teens with diabetes. If you’re facing a decision about whether your child should use a pump, this post may help by describing some of the benefits and challenges of insulin pump therapy for children and teenagers.
An insulin pump is a small, computerized device that is programmed to continually deliver basal, or background, insulin which also permits bolus dosages of insulin to be delivered to cover meals and treats. The pumps currently on the market are about the size of a cellular phone.
An insulin pump is used outside the body; no surgery is necessary for insulin pump therapy Rather, an infusion set is used to link the pump to the body. An infusion set consists of a little plastic cannula, or catheter, that is linked to a length of plastic tubing, which transports insulin from the pump tank to the body. The cannula is placed into the fatty tissue simply under the skin with a small needle, either by hand or with an insertion device. The needle is gotten rid of after the cannula is placed, and the cannula is held in place with tape.
Most children position their infusion sets on their abdomen or buttocks or sometimes their thighs. Infusion set site areas need to be rotated much like injection site places are turned. It is advised that the cannula, tubing, and insulin in the pump reservoir be changed every two days in children and teens, both to avoid infection at the insertion site and because insulin tends to deteriorate when maintaineded at warm temperatures, as it is in an insulin pump used near to the body.
Just rapid-acting or short-acting insulin is used in an insulin pump. Due to the fact that the pump is configured to provide a percentage of insulin constantly to keep blood sugar levels in target range between meals, there’s no requirement for injections of long-acting insulin. Pumps on the market today can be set to deliver different basal rates at different times of day or for the duration of specific activities.
Bolus dosages are not preprogrammed the way basal rates are. Rather, a bolus dose must be configured every time your child eats. Bolus doses are based primarily on the amount of carbohydrate the child is anticipated to eat. The bolus dosage can also be fine-tuned based upon the child’s blood glucose level prior to the meal or treat. If the blood sugar level is higher than preferred prior to a meal, the mealtime dosage may be increased. If it’s lower, the mealtime dosage might be reduced.
Due to the fact that bolus doses are customized to the meal they precede, pump users (or their families or caregivers) must want to inspect their blood sugar level prior to each meal or treat (along with at other times recommended by the health-care team) and should understand how to count carbohydrates.
Bolus doses can likewise be used to reduce random high blood glucose levels between meals. However, the need to offer regular between-meal boluses suggests that something in the diabetes routine has to be altered to avoid high blood glucose levels.
Also read: How to Choose The Best Insulin Pump?
Benefits of pump therapy
One of the benefits of using an insulin pump is having versatility with regard to mealtimes, sleeping, exercise, and household schedules. People who inject longer-acting insulins frequently should eat at particular times since their insulin is “peaking,” or reaching optimum efficiency, at that time. Were they to skip a meal or treat, they might develop hypoglycemia (low blood glucose). But the sluggish, stable, basal infusion of rapid-acting insulin provided by a pump does not have a peak, so it is not as important to keep a rigid schedule for when your child consumes, as long as any food is covered with a bolus dose of insulin when it is eaten.
Kids can also sleep late on the weekends if they wish, because they do not have to stress over taking an early morning insulin shot or consuming to avoid hypoglycemia. The pump is supplying a continuous dosage of insulin at a preprogrammed rate that ought to keep blood sugar levels in target variety.
Another benefit to using a pump is that dosage sizes are exceptionally accurate. Insulin doses can be fine-tuned to hundredths of an unit with a pump, something that would be impossible to do with a syringe. This precision can be especially practical in kids, who frequently need extremely small doses of insulin.
As pointed out earlier, pumps enable more than one basal rate to be programmed, so if your child’s blood sugar level tends to run high during a certain time of the day or night, the basal rate can be increased during that specific time period. Conversely, the basal rate can also be reduced momentarily to avoid low blood glucose at certain times (such as during or after exercise).
For all of these factors, some individuals experience better blood sugar control and fewer episodes of low blood glucose with an insulin pump. Some pump users also state that they feel more comfy administering insulin in public with a pump, because they just have to press a button to get insulin, rather than needing to prepare and inject insulin with a syringe or use an insulin pen.
Challenges of pump therapy
Insulin pump use likewise features some difficulties. One of those challenges includes body image issues. Some people do not like the concept of being tethered to the pump via tubing 24 hours a day, and they do not wish to stress over where to use the pump on their clothes. Some individuals who are more private about their diabetes do not like the presence of a pump, and they do not like having to discuss the pump to others.
Professional athletes who play contact sports usually detach the pump while playing, then reconnect later. Some discover the disconnection and reconnection a trouble or a worry. In addition, an insulin pump can just be detached for approximately about 1 to 1 1/2 hours, so if a game or practice lasts longer than that, your child might have to reconnect to his pump in the middle of the activity to instill some insulin.
Inserting an infusion set can cause pain and excite stress and anxiety in some children and teens. Another issue is the risk of skin infections that can happen at the infusion site.
If a pump malfunctions, there is a more instant risk of diabetic ketoacidosis, a serious condition identified by extremely high blood sugar levels, due to the fact that there is inadequate insulin in your child’s system. The pump needs to sound an alarm if the pump breakdowns or if there is a kink in the tubing, but it might not sound if the tubing is not entirely obstructed. Frequent blood glucose tracking is required with pump use to identify such problems as soon as possible on the occasion that the pump alarm does not sound. The possibility of a pump breakdown, such as a kinked catheter, while a child is sleeping is especially worrisome to some parents.
Some individuals likewise fret about the pump providing too much insulin, however this is a highly unusual issue since the pump has numerous safety checks to make sure that this will not occur.
Establishing basal rates and bolus dosages takes some time, effort, and additional blood glucose monitoring. Some diabetes care providers ask pump users to quick for 3 to four hours at a time to assist identify basal dosages, and some advise blood glucose tracking prior to and after meals to examine whether bolus doses are set properly. It might take a couple of weeks to a couple of months to figure out the right basal rates and bolus dosages and feel more comfortable with the dosing. And because insulin requirements change for growing children, it might be required to repeat the entire procedure occasionally.
Another challenge of pump use is the expenditure. An insulin pump and pump products can be more pricey than injections, so if you do not have appropriate health insurance protection, you may want to think about the extra expenses connected with pump use prior to acquiring one. Medical insurance normally repays 80% of the cost of a pump under durable medical advantages, but this differs, depending upon the policy. If you are having trouble getting insurance coverage for a pump, a pump company agent might be willing to speak with your insurance provider directly on your behalf.
Finding what’s right for you
The insulin pump is an exciting piece of technology, but it’s not for everyone. If you are wondering whether a pump would be a smart idea for your child, discuss this with both your child and your child’s health-care group. If your child is presently using a pump and is having difficulty with it, you and your child ought to discuss this, too, with your child’s health-care team. What’s important is that you discover an approach that works for you.