pump versus injections.

[Abi]

If control is suboptimal- either HbA1c or day to day levels in terms of hypos or hypers, despite your daughters best efforts ( carb counting, adequate monitoring and attention to all those other variables like physical activity- and making rational alterations to dose based on all of above) then she will probably benefit from a pump

 

[rossoneri]

Joan,
One other factor that I would bear in mind for your daughter if she does decide to try using a pump and it gets approval then be careful about when the change in treatment occurs. I think the first few weeks of being on a pump can be tough and troublesome as you get accustomed to the new approach to managing diabetes - just look at some of the posts of new pumpers on this forum. I would therefore try and avoid making the switch near, for example, a period leading up to exams.

It might help your daughter's enthusiasm if you point out to her that if she tries it for a couple of months and does not like either the regime or carrying it around with her 24/7 then she still has the option to switch back to her current MDI regime. I think it was recognising this fact that finally convinced me to give it go, before that most of the enthusiasm for me to switch had come from my (admittedly very good) GP and diabetic nurse who were both pump advocates and thought the pump was the best way of sorting the problems that I was experiencing with MDI. This and the fact that I also started to think that my reluctance to accept change was making me appear to be an old man!

Having made the switch I very quickly got the point where I became even more reluctant to switch back to MDI and this was despite the initial period being far from plain sailing for me.

 

[Patricia]

Agree with all said here - and Tom, thanks for capturing so clearly the 'lifestyle' bit. We were unusual on MDI in that our son's control was really quite good, esp for an adolescent. However, the pump has enabled MUCH finer control but as importantly, the liberation is worth every moment of commitment to pumping. I cannot stress enough the freedom my son now has in being with his friends and eating in restaurants, drawn out family meals etc. Yesterday for instance: in town with friends he guessed a bolus for a small ring doughnut out with friends. He then went back to a friend's where they made beans on toast - some of which he had to guess. He knows to guess on the low end when out and about. By 4pm he was 10 mmols - bit high, so he gave a little, painless correction dose to get in range.

He did what he wanted with no lows and no proper highs. As long as he tests and acts upon his tests, the trade off of 24/7 is control AND impressive flexibility.