My grandmother is 88 and has had hand tremors for most of her life. She is also diabetic and requires four insulin shots a day.

- 9am (10 units)
- 12pm (8 units)
- 6pm (10 units)
- 9pm (12 units of Lantus).

Because of her hand tremors, she isn't able to give herself her own shots. Up until recently, we have, as a family, been able to rotate our schedules in order to accommodate her. But now, her care has been too much for us to handle and short of sending her to a nursing home, I am wondering if you all have other options.

So far, I've made a call to her diabetes specialist and asked if there's a way to reduce the number of shots or if there are other sorts of insulin that she could take or if there's a new method (new technology) that could help her administer her dosage herself even with shaky hands (orally or rectally or a patch, I don't know). The doctor will get back to me next week.

I pose the same questions to the fine people on this forum here as well. Could you please educate me on insulin in general as well? I didn't even know there were different kinds of insulin.

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What about an insulin pen? The pump may be a good option. Speak with her doctor, the pharmacist or even speak with a physical therapist about what would allow her success with her injections.
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The Lantus is a slow acting insulin that is supposed to be in the "background" for about 24 hours. The other insulin is fast-acting and is taken in conjunction with meals.

I used to be on a schedule similar to your GM (with different doses). I have recently switched to a patch. This is a little plastic box that I fill with fsting-acting insulin once a day and then adhere to my belly. The device slowly dispenses a very small amount of insulin into my body throughout the 24 hour day. That is the "background" insulin. For meals, I press a button on the plastic box a certain number of times to get a heavier dose at that point in the day.

I think it would be hard to fill a new plastic box/patch with shaky hands, but that has to be done only once a day and it could be at a day (the same time each day) when someone could help. I'm trying to judge whether it would be hard to press the extra-dose button with shaky hands. I don't think so. I think one could do it even with unsteady hands.

This device is not considered a "pump" -- it is an alternate delivery device. Mine is called a V-GO. Perhaps it would help you to look into this online before you have a discussion with her doctor, so you'll know a little more about what is available and what to ask about.

The person you should really be consulting, though, is a Certified Diabetes Educator. That is who made the recommendation for me, and explained it to my doctor so the doctor could prescribe it. Insurance covers consultation with CDEs and it really is worthwhile for all diabetics and (I think) essential for anyone having problems that the typical treatments are not solving.

I wish you success! Please come back and let us know how this comes out. We learn from each other, Many elderly people have diabetes and this is a topic many caregivers deal with.
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Check into this:
Pump patch
These devices are basically insulin pumps that attach directly to the skin; they don't use tubing to deliver the drug.

“These are relatively new, and many models are still being developed,” explains Judith Pegg, RN, MSN, CDE, a diabetes educator at Beaumont Hospital in Troy, Mich.

“Pump patches are wireless, can be applied almost anywhere on the body, and are supposed to be very easy to use and eliminate the need to carry around the big pump.” One model, by OmniPod, is already on the market.
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I have heard of these things that rest on the skin and support the needle while you press the plunger. I'm not an insulin user, so I can't help you with the insulin question.
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