I think it is down to each person. I don't think you should force it, if she doesn't want one she doesn't have to have one. It is up to her in the end.

Personally in principle I agree with the doctor, it would be best to learn basic skills without the pump first. She will need those anyway with the pump.

I am not against pumps generally, just for me personally. I am not a fan of giving up long-acting insulin, I see it as a 'safety net' - whatever happens with my short acting doses, the long-acting will at least do something to prevent my blood sugars rising too fast so i can get a handle on the situation. With the pump it is short-acting only so if it jams or malfunctions ketones will appear very quickly.

I also feel I have more control over things with a pen as I am in charge of the insulin. I am wary of handing over such an important part of my health to a machine.

But that is just my personal feeling. I am sure loads of people are on pumps and love them.

I've been on an insulin pump for over a decade now. Well off and on. It has some huge pros to it and a few cons.

During a few summers I did go pumpless because even if they are rated and tested for water use don't believe it. I burned through quite a few of them by swimming with them on. They also don't do hot tubs well either but I don't recall being six and hot tubing all the time!

It is very wise to know how to do things without a pump as even these days I still have to go pumpless either because it faulted and I am waiting on the mail for a back up or for some other reason. It's then you go thank goodness I recall how to do this the "old" way.

It does require more testing for most folks. Although for me as I was neurotic about testing it wasn't much more. When you do have unexplained highs or lows it does take more debug.

You really don't get the most out of it if you aren't counting carbs and haven't figured out a carb ratio yet. It still takes some planning. For instance if I know I am going to do strenuous exercise but don't want to eat a snack for it I need to change the basel rate two hours ahead of time,

I have gotten just as good of a1c's on it as off it with about the same number of lows but then again I also wasn't against getting up at 2AM or 4AM for a snack and a blood test.

It can sting when being inserted (more then any regular injection has) and I will admit sometimes it just doesn't sit right and I have to rip out the infusion set a day or two early as it feels like some sort of bug bit me. This doesn't happen often but it does on occasion happen. To me it's worth it to not have to inject myself 4+ times a day though.

It does cost quite a bit more. Last time I got a pump it was $5000 without insurance and the infusion set and reservoir need to be replaced every three days or sooner if there are issues. Those items aren't cheap either.

I have found it to be a godsend though for my monthly cycle. My numbers drop horribly low for about two days and then horribly high for about three. And if you aren't on a steady schedule this is just something your long acting insulin doesn't change with fast enough whereas my pump can go to an alternate basel pattern and in two hours I'm back on my A game.

Same with sick days where all of a sudden I am high - no need to sit and do corrections all day I can just add a temp basel of a certain percent and I am good to go.

I also don't have a single issue with people seeing me bolus as they think I am just responding to a pager.

Thinking back on it - if I could have had it when I was nine I would have gone for it. At seven I was doing my own injections and we had fairly good numbers and I doubt you could have convinced me to go for it.

Definitely a very personal choice. The thing I like to mention is just because you go on it, doesn't mean you have to stay on it. So if you can and are willing give it a try. I still take pump breaks every now then and quickly realize life is easier with one!

Good luck to you both!

P.S. My mom says you will eventually stop worrying every night about her diabetes - LOL around the time you finally trust her husband. ;-)

thanks, helpful advice.

until the last two weeks or so we were enjoying the honeymoon phase, but that has clearly passed. i try to not test her too often, i really should do it more, but i'm trying to balance my obsessive need to test with the belief that if i make her miserable using her as a pincushion, she will resent her disease even more and not look after herself as well as she should. i really want her to have a say, and not over complicate things for her. i also want her to learn how highs and lows make her feel, so she can learn to regulate her diet/insulin rather than depending on me to analyze her numbers.

She is getting about 5 injections/day, two NPH and 3 novorapid. sometimes an extra shot of rapid if she needs a correction at bedtime. 6 shots a day is a big burden on anyone, esp. a little kid.

She is a kid, and loves her carbs (fortunately she doesn't have a sweettooth!) and doesn't really eat meat and never eats veggies. this makes managing her diabetes very challenging, obviously. i think a pump would help, and she is surprisingly good at knowing how to estimate carbs (for a 6 year old).

the other issue we have is that she has always been a bit of a grazer - prefers 6-7 equally sized mini-meals rather than 3 normal meals and small snacks. i don't think giving her a shot of rapid everytime she has a big snack/mini-meal is the answer, and her pediatrician wants her to eat normal regular meals, but i challenge him to have her live at his house for a few weeks, and see if he can completely change her ways, lol. not an easy feat.

her doc suggested we consider changing her NPH to Lantus or Levamir, but I don't know enough to make a decision. do these give better control through the day?

NPH tends to last somewhere between 12 to 18 hours. Thus the need to give it twice a day and you can see a peak with it. Lantus is "suppose" to last a full 24 hours and thus the need to only inject it once a day. It supposedly doesn't have a peak to it either.

For me it distinctly dropped off after 20 hours and so I had to time my supper shot just right to cover the extra four hours with a booster of humalog at my evening bolus.

Some people it really does cut down on that extra shot though. I didn't find it to give me more control or better numbers. It did give me a different flexibility in how I managed my diabetes. Some routines are just easier to follow then others.

I do think you guys could really benefit from an i-port. It will also give her an idea what an infusion set feels like without having to invest in an insulin pump first. I use these when on pump breaks as I tend to do the 7 to 8 small meals too and that's just to many pokes!

It needs to be changed every three days like your infusion set. However, it's only one poke for how ever many short acting insulin injections you do for those three days!

They don't recommend using it for both the long acting and short acting insulin as it does mess with how the long acting works if they are done one right after another. But for the benefit of not having to do 8 pokes a day I like it. Two pokes plus one every three days sounds so much more reasonable.

Plus if she isn't doing the injections herself this gets her another step closer. LOL At that age I was calculating what I needed, drawing up the syringe, and mom was double checking it and injecting it as I just couldn't do it!

I know my insurance doesn't cover them but they weren't that horrid I couldn't pay full price on my own for them. There's a few versions out there and here are two of them:

http://www.i-port.com/
http://intrapump.com/?portfolio=insuflon

With either one I'd recommend using LMX cream to numb the insertion spot with before putting it on. Works way better then an ice cube and make the experience all the better.

Hope you guys can find the happy medium. LOL I know every so often I have to search for it again even after 3 decades of dealing with it. So don't be disappointed to find those perfect numbers are elusive and an ever moving target.

P.S. Thanks for getting her input and involving her. One of the most empowering things my mom did for me was to ask my opinion on how "we" wanted to proceed. Even asking where I wanted to inject made me at least feel I had some control over it! Thanks again terrifico!

When I was diagnosed I was in high school and I felt the same way... With all these idiots pushing each other all over the halls, gym class, sports... I didn't want a needle in my stomach! The only difference is they actually had needles back then! Now it's a super tiny piece of plastic you can't feel at all! Tell your daughter this... When you have a pump... You can eat whenever you want. You are on no schedule with insulin where you have to force yourself to eat... All you do is put in the amount of carbs your eating and it gives you the insulin. If you decide not to eat, you won't have unsuspecting lows. If you take your sugar and it's high... You just hit one button and it puts in enough insulin to put you back to your goal. Getting my pump was the best thing I ever did. My a1c's are always in the 5 range. That comes with a lot of lows, but in the end, it's worth it!!

I am so glad we are in the age of pens and not syringes! I remember a high school friend and some family members having those - what a hassle!

We are really lucky to live in a province that covers pumps, etc. and my husband and I both have really good drug plans through work that cover all her testing supplies, pen needles, insulin, etc. so at the moment, cost is not a concern.

I will look in to i-ports. that sounds very promising, kind of a test run for pumps. I don;t think she would like actually wearing the pump, she's very active and it might be a bit cumbersome at dance class, etc. but i'm sure there are some great solutions to that, i just need to do more research.

She is doing her own injections at school and sometimes at home. she has been doing her own tests since about a week after she was diagnosed. She can't go to school unless she does her own injections, but there is someone at school who calls me with her BG, and I tell her the dose to give, she then double checks the dose, and supervises the injection. its a pain but our only option because my husband and I both work way too far away to drive back into town at lunch time.

a pump would make the school part easier but i don't think we are quite ready yet.
thanks for the great advice everyone!