After some years of experience,

these parents would like to share some helpful hints:

From: Spainrk@aol.com

I would be happy to add some helpful hints.

My son Will has been pumping for 1 1/2 years starting at the age of 3. Young children have some unique pumping problems. Probably the most frustrating thing was figuring out how to keep the pump in! My son is a typical active boy who constantly wrestles with his brother and two sisters or is crawling on the ground or climbing trees. Besides this we have a swimming pool that he practically lives in during the summer. All these things presented us with challenges to keeping the pump set in. The method that works best for us is to first spray his skin where we are going to insert with Tincture of Benzoin. Next we apply a piece of tape, we use IV 3000 then we insert a Silohette insertion set through the tape. Finally we cover the whole thing with another piece of tape with a hole cut in the middle. We find the Benzoin not only keeps his tape secured it also protects his skin from allergies. The Silohette set works best for a child my son's age since you can visualize the cannula and always know if it is in or not.

Another key to keeping a pump set in is to buy the shortest tubing made and to keep the tubing wrapped around the pump and the pump placed into a deep pocket. My son even wears pants or shorts with deep pockets to bed. By doing this the tubing rarely gets caught and the pump is out of sight out of mind.

My son's HgbA1c's have consistently been in the low 6's. I feel the secret to our success is to accurately weigh and measure all food. If a food does not have a label I weigh it in grams and calculate the amount of carbohydrate in the food by using Carb factors. I have figured out how much insulin my son needs per 1 gram of carbohydrate. After I calculate how many grams of carbohydrate he is eating I then multiply this by the amount needed per 1 gram of carbohydrate. This gives me an exact amount of insulin to give per the pump. For a small child even being off by .1 can make a difference!

Some other tips: Always be prepared by carrying extra batteries, tape and insertion sets with you. Check your child frequently for best control. For small kids, Sweet Tarts which raise the blood sugar about 10 points or so per tart are great for lows. Follow this treatment with a food high in protein, my son likes Kudos bars or peanut butter and crackers. Make sure you treat these foods with the appropriate amount of insulin. Small kids may need their basal rates changed often due to growth spurts. Be prepared to check basal rates, especially at night by having your child fast after dinner and then checking blood sugars every 3-4 hours.

My final tip is for those of you with young kids pumping. Find yourself at least one other person other than your spouse that you can train to take care of your child and occasionally take a break! Diabetes care, especially with a young child can be exhausting and cumbersome. I have a good friend who I have taught over time every trick I know. She can insert the sets and calculate amounts of insulin as well as I can. For the first time since Will was diagnosed with diabetes almost 3 years ago my husband and I have been able to go away overnight! That little break made all the difference in the world to me, it was very refreshing.

Good luck to all of you caring for children with diabetes. Don't forget God is in control and prayer really does help!

Kathy Spain, Mother of Will, age 5

----------------------------------------------------------------------

From: dchafe@ns.sympatico.ca

If you are not at home, and you run out of insulin, you can do the following. Disconnect, take the syringe out of the pump, take the tubing off of it, pull some air into the syringe, connect the tubing, prime (or bolus) until you see insulin coming out from the infusion set, reconnect, and that will keep you going for awhile.

Or, if you don't want to do that.....if you run out, (I haven't had to do this yet) have a syringe with you, withdraw insulin from the tubing and use MDI until you can get a refill.

Bubbles...hate em....still get em.....learning to live with them!

We do an increased basal rate for Erica when travelling long distances. We add an extra .1 per hour basal, starting about an hour prior to the trip. Otherwise, we find she keeps climbing, climbing and climbing with the total lack of activity in the car.

Don't be afraid to increase the basal rate if sugars just won't stay down. As long as you are still testing very frequently, it shouldn't be a worry. We have had to, on a few occasions, increase Erica's basal as much as .1/hr across the board for a few days/week at a time (regardless of where the infusion set is). I guess I have to attribute it to hormones or 'the black hole', but it eventually passes and we are back to regular basals.

Well, that is my little contribution. Hope it helps out!!

hugs, Barb

-----------------------------------------------------------

From: Emily Adamski

Getting the air bubbles out of the syringe... tap the syringe against the table (not too hard of course) so that all the bubbles rise to the top and are easier to get out. I've had great success with getting them out that way. Or tapping the syringe with a pen works pretty well too. Avoiding hypertrophy... Be sure to rotate so that you don't get any "bumps" from injecting your pump site in the same spot. Try using your lower hip. It doesn't sound comfortable to some, but I found it is the same as my stomach.

If you find that you run out of insulin before it is time to change your site frequently there is a piece you can take out inside the pump to enable more insulin to fit into the pump. The neck of the syringe will stick out but it sure beats changing your site before you really need to.

Where to wear the pump for sleeping... I hook it to the waist of my pajama bottoms, on the front since I don't sleep on my stomach. It doesn't move around, and therefore I don't notice it is there while sleeping at all.

Having a tough time inserting your site? Some days it just seems so much more "stressful" changing your site, even though you know you can do it. I sometimes find I have to walk away for a few minutes to just forget about it so I wont tense up. If you tense up, it'll just hurt more and cause stress...lol

Tape problems? I find the tapes Minimed puts with their sof-sets don't work for me. One of them doesn't stick to me and the other gives me a little rash, so I found that Tegaderm (and IV tape) sticks well for me, even through swimming all day.

Going to be at the beach? Keep the pump out of the sun in a cooler (but not right on top of ice). If you don't want people to see the pump site (wearing a 2 piece, or boys) try your lower hip as in insertion site. Be sure if you take off the pump to cover the basal rate you're missing.

If going to be active for a while... Set a temporary basal rate to avoid unnecessary eating if planning on wearing the pump through strenuous exercise. Set it a little before you start exercising though so that you wont go low early on.