I am 13 years old and have had type 1 diabetes since March 4, 2003. My A1c has never been above 6.9 since I was diagnosed. I give myself insulin injections of NovoLog four or five times a day and take 10 units of Lantus at bedtime. My blood sugar readings are pretty much normal and rarely go above 250 mg/dl [13.9 mmol/L]. I want to try using an insulin pump, but my mom thinks that my blood sugar readings and A1c’s are good, so I should stick with the injections. I think it would be a lot easier, a lot less hassle and less painful to use a pump. What do you think?

Making a transition to an insulin pump is a tough decision and many factors must be considered.

In very broad terms, remember that an insulin pump is not a necessity, but rather simply “another way” of giving insulin. I can understand your mother’s “if it isn’t broke, don’t fix it” approach: your glucose levels are good, so don’t upset matters.

But frankly, I do agree with you. If you have been able to successfully dose insulin five to six times a day, have been dosing insulin appropriately for your carbohydrates, and you are mature and can handle the big responsibility and extra work of a pump, you might want to give this serious consideration.

You should read Is the Pump Right for You? to try to weigh whether pumping is right for you. Have a series of discussions with your Diabetes Team members. If you have only recently begun the multiple dosing regimen you use now, I would advocate that you demonstrate continued good control for at least six months on that regimen before progressing to a pump, but your own physician may have different ideas.

Remember, an insulin pump is NOT an artificial, mechanical pancreas! It is a computerized device programmed to give insulin at various times. To pump, you must still test your blood sugar many times a day and count carbohydrates and give insulin based on those carbohydrates at meals. Of course, you tell the pump to dose the insulin.

Currently, while on shots, if your glucose is high, you simply give more insulin. But if on a pump, when your glucose is high, you must first do many steps to test the reliability of the pump, the tubing, the insertion catheter, change sites, give insulin through the pump and some other steps. If your glucose were to stay high, then you must give a shot.

A pump is more work, but an excellent way of giving insulin.

DS