Tuesday, December 26, 2006

Insulin Pump Mayhem

My son is an insulin pumper. He has pumped for a few months now, and though it was dreamy at first, and stillour first choice in insuin delivery..... I sort of miss lantus.
Lantus insulin, for anyone who doesnt know is probably the best intulin breakthrough since the discovery of insulin. NPH was swell back in the day, because it eliminated how many times needles had to go into the skin... and back when you had to re=boil this gigantic needle for each use.... that was handy... fast acting insulin was cool in that you could inject sooner before you ate, (or right after) and it did not stick around for as long, causing lows.
But it was insulin glargine (lantus) that simplified life for a lot of diabetics.... One low blood gluscose level all day long... virtually no lows. scarcely a night time low and only lows from toomuch excercise or not enough food.... and Lantus is Peakless... so... no surprises.
But Lantus made for More shots... which is OK now, because we have teeny tiny insulin needles that you cant even feel and they come in supershort.... so you could actually sneak up and give your diabetic child a shot of lantus as they slept... they would never know that the needle was in them. But, unfortunately, you try that once and find out that Lantus does something special as it goes in... It burns. The injectee gets a burning sensation because Lantus crystallizes under the skin.... which is what makes Lantus so great, it crystallizes and then only puts out bits of itself throughout the day. It lasts at least 24 hours. But forget about sneaking up with Lantus....
sneak up with humalog if you need to fulfill your urge to give that shot, but not Lantus. You might wind up with a black eye.
So, pumping.
Pumping is great, except for that if, for whatever reason, you go high, then you can go really high. You might get an air bubble or you might have your tubing cut for some reason. You might forget to change your site every two days... and then there you have it. High blood sugar... up to maybe 600 pretty quickly.
With Lantus you are not bound to tread that high unless it is maybe... because of some overdose on chocolate.
So with the pump, you change the infusion sets, you change the battery, you have to put this thick needle in with a plastic catheter... It is harder to do.
The marks on the skin stay longer. the tape causes breakouts sometimes. Lipodystrophy is, again a problem. You run out of sites quicker, as you are eliminating the arms, the legs, etc. So if you have a smallish 9 year old like I do, you end up going for the same spots time after time.
I know repeated insulin use can cause hardening of the fatty tissue if it is injected time and again in the same spots... Makes me wonder what inhalable insulin will do to the lungs.
Insulin pumps are great for a lot of reasons, but they are not the cure, and they dont always give you a better read on your A1C...
But they look like a pager and what nine year old would say no to that...

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