"After one week on the two-shot plan, I knew it was not going to work out for us. We were down to feeding our daughter suckers for meals because she knew if she didn't eat, she would be given sugar to prevent a low and passing out. Two very, very long months later the endocrinologist switched our daughter to a long-acting & short-acting shot regimen. This didn't work for us either. The shots were supposed to be a maximum of four per day and ended up being eight. My young child spent all day afraid to be around me and miserable. After three months of multiple injections, we were able to get her an insulin pump. Life began again. The insulin pump did nothing less than give my child her childhood back. I am eternally grateful to the pump companies for bringing this device to market and thank God every day we have it." 
-Parent of a T1D toddler
-Parent of a T1D toddler History of Insulin
It seems both miraculous and bizarre that science can manufacture biosynthetic hormones, and they work. A substance that looks like water in a vial and smells funny saves my child's life every day. Years ago, porcine (pig) insulin was used because it was most like human insulin. The history of the discovery of insulin is nothing short of amazing. You can view this history in its entirety at the following website.
CAUTION: Although this presentation is fascinating and gives a large dose of perspective, some of the imagery I found very disturbing. Overall, I was glad I watched it, but I will never forget the pictures of the suffering adults and children.
Types of Insulin
The following article was found on WebMD. It is an excellent analysis of the insulin options available to your child.
There are many forms of insulin to treat diabetes. They are classified by how fast they start to work and how long their effects last. The types of insulin include:
- Rapid-acting
- Short-acting
- Intermediate-acting
- Long-acting
- Pre-mixed
The following chart lists the types of injectable insulin with details about onset (the length of time before insulin reaches the bloodstream and begins to lower blood sugar), peak (the time period when the insulin is the most effective in lowering blood sugar) and duration (how long insulin continues to lower blood sugar). These three factors may vary, depending on your body's response. The final column provides some insight into the "coverage" provided by the different insulin types in relation to mealtime.
WebMD Medical Reference provided in collaboration with the Cleveland Clinic
Shot vs. Pump Therapy
No one treatment option works for everyone. Children successfully use shot therapy (either with syringes or pens) all over the world. It is the norm right now for newly diagnosed T1D children to be initially placed on shots and then, after an arbitrary about of time and history of successfully managing blood sugars, the endocrinologist will place the child on an insulin pump if an interest is shown. There are some Children's Hospitals, Kansas City and Stanford to name two, that regularly place newly diagnosed children on pumps immediately. Before you even venture into these waters, be sure you check with your insurance company about coverage.
Insulin pumps cost around $5,000 a piece and that amount does not cover the various supplies you'll need to replenish every two or three months. Finally, if your endocrinologist is not a fan of technology to manage T1D, then you may want to seek a second opinion. A physician should not stand in the way of alternative treatment options. Especially when pumping is known to improve glucose control.
Recently, Diabetes Forecast came out with a direct comparison of insulin pumps on the market for 2011. If you are in the market for a pump, it gives a wealth of information.
The following sites give some additional information.
Insulin Pump Manufacturers
Most pump companies will allow you to have a "trial" with the insulin pump to give you and your child an idea of what pumping is actually like. No matter the insulin pump you choose, pumping is a completely different--and at times more complex--treatment option. But don't be scared by that. I don't know a single child that switched back to injections once they got used to pumping. The flexibility it offers is life-changing.
Once a child is pumping, some parents feel relief not needing to "feed the insulin" or chase down their children for several injections each day. You will also have total control over the basal and bolus amounts your child receives all day, every day. You may dial insulin up or down as you see fit. That being said, there are usually more blood checks and the learning curve is pretty long: I'm tech savvy and it took a good 4-6 months for me to be completely comfortable. But never forget that your Diabetes Team and pump reps are there for you. They will fully train and advise you on all aspects of pumping.
Note: Your child will only use short-acting insulin in their pump.
Coping and Hoping
a place for loved ones of children with type 1 (juvenile) diabetes
Treatment
