Endo doesnt want to do a pump

So my son is almost 4 and was diagnosed at 2. I made a thing about putting him on a pump and got some very great and supportive feedback on it. Everyone was telling me to go for it! The issue is that my endo REFUSES to put him on a pump until we have all his numbers steady but I have a Houdini food thief that I cannot keep out of the pantry for the life of me, he climbs on top of the fridge, over baby gates, the shelves of the pantry, whatever he can to get food the second I’m getting ready for work or using the bathroom or anything that requires me to not look for a few seconds. We cant keep him stable without a pump because despite knowing he needs to ask and will get whatever he wants as long as we do what he needs he still wont ask or anything. He KNOWS we will give him anything as long as we check and dose but still will not ask. Anyone have any recommendations for an endo in the salt lake valley or suggestions to help us convince dr Raleigh? She doesnt seem to listen to a word we say and even the school nurse is over her crap but idk who else to go to

Cosette @Lindsay1152017, I can hear your grief and your frustration.
An insulin pump is not a “cure” and I can see the endocrinologist’s point of view. I also see your thinking on how much easier it would be to “cover” your son’s eating habit with doses from a pump rather than by using a needle & syringe or a pen with rapid-acting insulin. Your child’s doctor appears to be looking at your 4 year old’s overall health and long-term survival.
In order for a pump to be effective in your son’s situation of sneaking foods, you would need to know at least three factors to dose him accurately - to my knowledge there isn’t a pump that counts carbohydrates passing through the gullet:

  1. The carbohydrate count of food going down the gullet;
  2. Current body glucose level;
  3. Active insulin in his body - to avoid insulin stacking;
  4. Additionally - will activity be more intense or less intense than anticipated when his basal rate was determined.

One action you could take if you suspect that your son has eaten, is to do a finger-stick and injection after you use the first three factors mentioned for a correction dose. No kid wants to be constantly poked with a needle - and that goes for me now in my seventh decade living with insulin. Something that may be in your doctor’s mind is that she doesn’t want your son to add a “lifestyle” [type two] diabetes to his present TypeOne diabetes which is able to be managed.

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Great suggestions, but I suggest you find an endo who will listen, explain her rationale, compromise, etc. You are in this forever, you need a teammate endo. Are there other T1Ds in your community who could suggest another? Get a 4 year old stable with injections? I can’t imagine that, but I guess it’s possible. I think you would have a lot better success with something like a Tandem/Dexcom combo if that’s a possibility.

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If you’re thinking of an Omipod or T-slim pump, you could try to convince your endo to approve a Dexcom CGM first. I think that would help WAY more than a pump to keep him in range anyways. You get BGs every few minutes and can correct accordingly - this way if he does sneak a snack in without you knowing you’ll get an alarm on your phone when he starts to rise rapidly.

Then maybe with improved A1c and tighter control your endo would write a script and medical necessity form for a pump! I personally would still try to get another endo BUT that may be a way to get to what you want for your kiddo if that’s not possible! Good luck!

The food sneaking is so scary to me as a mom of a t1d. Do you know why this is happening? Could you get rid of some of it and not keep it in the house (aka “Sorry other kids we are a family and a family is a team”) or change his diet? We just found the 4 carb treat of a small keebler ice cream cone with whipped cream in it. Ridiculously healthy? No. Paired with a cheese stick? Not crazy. Super cool and satisfying to my 6yo? Yes. **please do not let the suggestions imply you are not already making the best decisions for your child. I’m just throwing some things out there. Again, this seems terrifying. I would definitely tackle this issue first possibly with a family therapist/child psychologist/nutritionist, etc.

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