Injections better than the pump?

Nobody wants to say that giving oneself six or more shots per day is preferable to the simplicity and elegance of using an insulin pump. So I expect to hear some screaming from the DOLC.

I have been thinking a lot about this issue since we found out that M had been getting "creative" with her diabetes management.

To be sure: with the pump one still must check one's bg six or more times per day, which still requires the sticking of fingers with little sharp things called lancets. One must also change the infusion set, a set with tubing attached to insulin, with a little straw, or cannula, sticking into the skin. That means that every three days or so, one must use a needle to get the infusion set into one's skin so that the pump can deliver the appropriate insulin.

So life with the pump is not entirely needle-free.

But it is way more convenient, especially if you want to take a snack.

Which is why I feel that I can argue that injections might be better for some patients. 

One of the reasons I noticed that M's bg numbers were manufactured is that we were at the beach, and she was eating constantly, like most teenagers. On top of that, the foods she was eating were not optimal PWD fodder.

Because of safety precautions put in place by pump manufacturers, however, M was not able to bolus every time she ate. In an effort to prevent life-threatening lows, she cannot bolus within a half and hour of her last bolus. While this means that her life will be safer, it also means that if M is pigging out, and especially if she is not able to bolus for the extra food, her bg will necessarily be higher than normal.

When her reported bgs were in range, or just outside of it, I knew something was up.

Now, when M was using the insulin pen, we didn't have this problem. If she wanted to pig out, she would plan her snack, and give herself an injection. If she wanted to eat more right away, she would have to give herself another injection. Since injections are unpleasant, as well as a hassle, she often chose not to pig out - a clearly healthier decision.

Maybe some kids are not suited to use the pump. It says a lot that after three months on the pump, M's bg went from 6.4 to 9. 

As M enters high school and becomes increasingly self-conscious about appearances, she will likely want to do whatever her friends are doing: eating pizza, eating popcorn and candy at the movies, and generally assuming that she will live forever, like most teens.

What she will not want to do, I am guessing, is say that "I need to count carbs, so no thanks, I'll pass on the baklava, Bosco, Blizzard."

The pump is making it easier for M to blend in and make less of a big deal about her diabetes. But I am on the fence about whether that's a good thing or not. If she flies under the radar too well, she may not keep herself as healthy as she should.

I hope that she will defy the teen odds, and put her health ahead of her need to conform.

Being a high school teacher, however, I have my doubts.

Unfortunately, I will just have to wait and see. Only time will tell.

"That's okay, I can bolus for that."