So for those who may have missed the last two blog posts, we have been researching, and debating, and trying out insulin pumps. We narrowed the playing field to our top two contenders: the Insulet OmniPod and the Tandem t:slim. After about 24 hours with a demo pump, Leah chose the t:slim, but we were still awaiting the final word that our insurance would definitely cover this rather expensive little piece of high-tech medical equipment. Well, I'm happy to announce that...we have a winner!

The t:slim wins the insulin pump debate in this family, but Leah is the real winner here! Her pump arrived via UPS today! She can't wait to get her formal training and start using it. As with any change, questions are bound to come. I've realized through my conversations with family and friends that this "pump thing" is a bit of mystery to the general public who don't deal with Type 1 Diabetes every day. So let me try to explain how it works...comparing Leah's current way of dealing with her diabetes, to her future way.

Currently, Leah takes two kinds of insulin by injection. She gives herself a dose of slow-acting insulin every morning, which is released over a period of 24 hours into her bloodstream. Then at each meal she gives herself a fast-acting dose of insulin. The amount she gives at mealtimes and bedtime is determined by a calculation that includes her current blood glucose (BG) level (which she finds with a drop of blood from her finger and a monitor), as well as the number of grams of carbohydrates she is taking in. Although it is possible to have a snack mid-morning or an hour or two after lunch, this would usually require another injection, something Leah tries to avoid.

Leah's handy little insulin pens easily dial up the number of units she needs, but she still needs to perform the calculations, attach a needle, determine her injection site (belly, thigh, arm, etc), stab the needle into her skin, push the button to inject the insulin, and then safely dispose the needles. She typically does this five times per day. This hurts. She doesn't cry or complain, but there are occasional winces, sighs and moans, that let us know she really doesn't like injections.

In the future, on her t:slim, Leah will only need one kind of insulin, which is delivered in two different ways. The pump will deliver "basal" insulin in tiny amounts continuously throughout the day. Then at mealtimes and bedtime, she will check her BG level (with a finger prick), and enter that number into her pump via a touch screen. She will then enter grams (or units) of carbs she is eating. The pump will do the math...check with her to be sure she agrees with the amount, and then deliver the "bolus" insulin when she presses "go." If she wants an additional snack between meals, she can tell the pump to give her a bit of insulin to cover it. If she's exercising, she can also make adjustments with the push of a button.

Rather than having five daily injections, on the t:slim Leah will need to "hook up" the pump to her body with a tube and tiny cannula that goes under her skin and is held in place with adhesive tape. Using an insertion device, she will change this tube set-up, and refill the insulin cartridge in her pump onceevery 3 days. Thankfully, we know from our trial demo, that this "hook up" was not painful for Leah. She will continue to use finger pricks to check her blood sugar, but she doesn't seem to mind those either.

So...less pain, all gain. We expect that Leah will gain flexibility, convenience, and tighter blood sugar control. But the proof is in the pudding, as they say. We hope to see the t:slim live up to our expectations in the very near future. Stay tuned...

We have a winner!