January 20, 2009
Daily Care
Question from Napier, Illinois, USA:
Our daughter was diagnosed in 1996 at age three, but, since then, has never needed hospitalization or any other special medical care as a result of her diabetes. We usually try to time site changes so that they happen while she is sleeping. We then check her several hours later to make sure everything “took.” Sometimes, though, we are just too exhausted to think clearly and miss the late night confirmation test. Usually, if her sugar level becomes very high in the night, she awakens to drink water and to go potty. But at the risk of sounding like a paranoid parent, I would like to know the chances of her going into severe DKA while she sleeps and we could awaken in the morning to find her in a coma.
Answer:
The odds are quite low. However, you may want to discuss the timing of pump catheter set changes to a different time with your diabetes team. For instance, if the catheters were changed in the morning, should there be a site problem, you would recognize this from daytime monitoring rather than waiting for many hours overnight.
SB
[Editor’s comment:
If you are concerned about the pain of doing the site insertion, you should ask your diabetes team about the use of topical numbing cream or ice on the skin to lessen, if not eliminate, the pain. Although long term use of the cream is not recommended, this may be helpful at first. You might also discuss the use of different infusion sets, some of which may be less painful upon insertion.
BH]
