I am 16 years old, and have had diabetes for over 10 years. I was on insulin shots from the time I was five until I was 13 when I finally talked my parents and doctor into letting me get an insulin pump. They were very supportive of me and things went well, for a while. My A1c came down from 9.6 to a 7.6 without too much hard work. However, now my A1c is back in the 8.0-8.4 range.

I am very discouraged, not just with my A1c levels but with my entire diabetes control. I feel as though I have no control. A lot of my diabetic friends are still on shots, and it seems their life is “carefree”. They don’t have to worry if their site is working, or if their site is going to fall out after basketball practice.

What would happen if I decided that the pump was not for me? Would my doctor and parents think that I was a failure because I came off my pump? Can’t shots work just as well as an insulin pump? And, with sports, because I play basketball, volleyball, & track, wouldn’t it be easier to not have to have a site to worry about if it is going to fall out? I put plenty of tape on it and that adhesive stuff my skin. I am very discouraged about it all right now.

I think you are making mature and thoughtful questions. My guess is that your doctor and parents would be impressed and proud as to how you are thinking about things.

I have several teenage pump patients who have requested “a break” from their pump. Everyone recognizes the advantages of a pump, but you are right on: when something is wrong with your glucose levels, you must go through an arduous path of doodling with the pump first before you make an insulin injection. With shots, you just “give a shot.”

One of my patients is the daughter of one of my nurses. This teenage girl is an active swimmer and found the pump to be a hassle during swim season and thus went back to a similar basal-bolus insulin plan using long-lasting Lantus and NovoLog (or Humalog) as shots. The mother then commented how much of a relief it was to not have to fret about the pump working.

I have another teenage patient who was the center for her high school basketball team. The pump was also a problem for her in her active life. She also wanted to stop pumping for awhile but did not like the daily injection routine. For her, we used an Insuflon. You may want to talk to your diabetes team about that. The Insuflon is essentially an insulin pump catheter that you change about every 5 days but you can give your insulin injections into this catheter! So, it has the convenience of pumping and shots.

After a break from pumping, and as your schedule changes, you may find when it is right to go back to the pump.

DS