Site change

Site change. That׳s how we call the procedure of changing the site in which my daughter's insulin pump is connected to her body. We need to do it once in every three days but I admit that sometimes I let her get away with it and wait until the fourth day. This way we spare about two site changes per month, that's 24 less site changes per year and that's a lot (well mainly for me). Unfortunately we cannot go beyond four days without taking the risk of local skin infection. Of course I have to be grateful for modern diabetes treatment. It wasn't until Insulin was discovered in 1921, that diabetes mellitus was considered a fatal disease. When the first insulin injection ever given, saved the life of a dying 14 year old diabetic boy in Canada, it was thought to be a cure. Since then a lot of money and effort was put towards developing better and smarter insulins, better ways to administer the insulin and better ways to estimate the optimal amount of insulin needed, at first by checking the amount of sugar in urine and then, when found to be not reliable nor accurate enough, ways to check sugar in blood, and in the home setting rather than the clinic or hospital setting since this is something that has to be done at least 4 times per day. It wasn't until several years ago that people finally realized that using insulin is not a cure for diabetes, it is merely a way of treating the symptoms and in order to really cure, a different solution is needed. So I am grateful for the insulin pump, that replaces the routine 4 insulin injections per day and the strict diet regimen, by 2-3 site changes per week and the freedom to eat whatever and whenever she wants, a great advantage especially when it comes to children. The insulin injections have to be taken before or immediately after a meal, to cover for the carbohydrates eaten, since in type 1 diabetes the body doesn't produce enough insulin and so is not able to use the sugar in the food for energy. Now, what would you tell a child that had already got her insulin shot, had her dinner but now wants some more? Or a dessert? Or is going to a birthday party and wants to have some candy or cake? You always have the option of giving her another insulin shot (that will make it an extra shot in addition to the 4 she has to take anyway), you can just tell her no (not un option for me, the over-protective mom that is always sure my kids didn't have enough to eat) and you can suggest she would save it for later, for the next time she is going to get a shot anyway. That was my preferred approach, but an insulin pump just solves all of these problems at once. It is connected through a port that goes into the skin (well, actually to the fat tissue - any place that you can 'pinch an inch', but in my daughter's case it is pretty hard to find a pinchable area so we just settle for skin) and infuse insulin 24/7. It is optimally programed to the individual's needs (to imitate the basal insulin secretion in the body) and insulin can be added (it is called 'bolus') every time sugars are eaten. It can also be operated by the child herself, unlike injections which require technique. These are major improvements compared to shots but still not a cure. We still need to check the blood sugar by pricking my daughter's fingers at least four times per day (our endocrinologist actually says it should be more like 6-8 times per day but we try to keep it sane). And even after more than two years of doing site changes for the pump at least twice a week, it still is a procedure, still causes some fuss from my daughter's side and still makes me feel bad for causing her pain, even tough I know it is what keeps her healthy and well. I still wish everyday, but especially after every site change, for a cure for type 1 diabetes. A real cure.