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August 9, 2010

Insulin Pumps, Mental Health

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Question from Parker, Colorado, USA:

My 16-year daughter was diagnosed in 2002 when she was seven years old. The past two years have been very difficult for her in terms of control–hormones, problems with insulin delivery through her pump due to scar tissue, etc. As a result, she has virtually given up on taking care of herself. She seems very down and talks often about how she “doesn’t want to live like this.” Her latest A1c was 12.7 and her average blood sugar is in the 300s mg/dl [16.7 mmol/L to 21.8 mmol/L]. I’m trying to find some productive ways to help her. She indicated that she would feel better if some of the scar tissue around her pump sites could be reduced and, in the interim, using some products that would reduce the pain of set insertion (her skin is always bruised and really sensitive). Can you give me some advice on helping her deal with her frustration, on scar tissue reduction, and options for reducing pain at set sites?

Answer:

From: DTeam Staff

I don’t know if any of this will work but let�s give it a try! As a person who has lived with type 1 diabetes for almost 50 years now, I can totally appreciate your daughter�s frustration. All of us get to certain places and times on the “road” where we just melt down form all the pressure and hard work. Please know that this is totally “normal” and not to feel bad about feeling bad.

It really does sound like your daughter, and you, just need to have a planned “diabetes depression day” or meltdown, where you just give in to the anger, frustration, sadness, exhaustion as a way of getting through it as opposed to continually battling it. I do this myself, where about every three months, I schedule my “breakdowns,” stay home, watch videos and have myself a real pity party! Afterwards, I feel so much better; I still have diabetes, it hasn’t gone away, but I feel like there�s been a release of steam and I can get back to the chore of getting on with my life, with a smile.

Regarding the sites and scar tissue, each of us has a little bit of a different reaction to the insertion of needles, whether they be injections or insertion needles from infusion sets, but I’m a little surprised that your daughter is experiencing such difficulty if she�s been appropriately rotating her sites over the years. I’m not questioning your comments and reality, just a little surprised. If she hasn’t done that, she needs to start doing that and letting the overused sites heal, meaning, to avoid those sites completely for several months. The best people to talk to about this are the Clinical Managers from the pump companies. They have a wealth of knowledge about how to deal with these difficulties and you guys should definitely contact them for resources and information. This is not an “empty” just push them on to the next professional recommendation–these guys really know this stuff! They can recommend where the best alternate sites are, different ways of taping it down and the best infusion sets to work for you.

As you’re getting more information about the sites and alternative infusion sets, you might also think about seeing a therapist. All of us with diabetes need a little help in this department to be able to stay in the race. It�s not a sign of defeat; it�s a sign that you’re working hard and that you need some assistance in putting words to the feelings that come up and being able to articulate them for yourself. This is extremely healing and just one of the tools that those of us running the marathon have in our tool kit. Please take a look at my article, Diabetes and Depression: Some Thoughts to Think About. I hope it helps you guys put some of your situation into perspective.

JSW