Choosing the right pump

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Given this wealth of choices, how do you choose the pump that's best for your child? You're about to purchase a device that costs more than $6,000 and will require more than $1,500 worth of supplies per year, so take your time and don't select the first pump you look at. Take these factors into consideration:

^ Your child's doctor may be very familiar with one or two pumps and feels most comfortable using them. That may be a very important part of your choice unless you want to choose a new doctor with your child's pump.

^ Your insurance company may prefer that you select one particular pump. However, if your child prefers another, don't give up easily on the pump of his choice. Many insurance companies will permit the purchase of an insulin pump that isn't on their preferred list if you provide convincing evidence that your child needs the special features of that particular pump.

^ The need for a waterproof pump influences which pump you can use.

^ If you or your child have problems with your hands, some pumps are easier to program than others.

^ Your child may prefer a pump that's silent rather than a pump that clicks as insulin is delivered.

^ A pump that can be set to deliver the smaller basal rates is better for small children.

^ Representatives of the pump company will work with you to help you understand how to program the pump, so you should be comfortable with them.

^ You should know ahead of time if the pump uses any infusion set or requires a special one that you have to order.

^ Whether or not you receive a backup pump immediately if there's a problem is an important detail.

Your child can wear the different pumps (without insulin) to get the feel of them for a few days. You can get them from the pump manufacturers.

I find that my insulin pump patients use very few of the special features that their pumps provide. They average about five different basal rates in 24 hours and don't change patterns very often. They don't use temporary settings very often either. The tendency is to use lots of features when the pump is new and then back off after you've been using it for months.

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