From Columbus, Ohio, USA:
My son was diagnosed when he was 15 months. He is now two and I am curious to find out if and at what age the insulin pump would be appropriate for him. He has had pretty good A1C's (between 6.8-7.2) but I don't want to bypass any technology that may help him have a more flexible and still healthy lifestyle.
It sounds like you take wonderful care of your child! I would speak to a knowledgeable diabetes care team about the advantages and disadvantages of the insulin pump for your child. I will tell you that, at this time, most pediatric endocrinologists are not using pumps for young children. However, if you are interested in pursuing the pump, there are centers which use pumps more frequently with young children.
You are right in that the pump may offer more flexibility in lifestyle/food for your child. The down side is that we don't have a "closed loop pump" yet (where the glucose is monitored and the pump responds with the appropriate insulin needs). Therefore your child would need to always be with someone adept in pumping. The current technology requires a mature ability to problem solve. If there is a problem with insulin delivery, after a few hours ketosis and ketoacidosis will be starting. Ketoacidosis can be life-threatening. Frequent blood glucose monitoring needs to be done (you are probably already doing this.) Other issues include keeping of the pump and infusion set in place, preventing damage to this expensive item in a young child.
Another thing to consider is the goal for blood glucose levels in young children. We would not be aiming for normal readings, even with a pump. Frequent hypoglycemia is to be avoided. If your child is having problems with frequent hypoglycemia, and you have tried different insulin injection regimens, you could speak to your team about whether a pump would help.
In summary, the pump can be wonderful in carefully selected people. It is not an "easy fix" to diabetes, and from your letter it sounds as though you know this. When continuous glucose sensing is available, you may find different views emerging about the pump in young children.
Original posting 13 Jul 1998
Posted to Insulin Pumps
Last Updated: Tuesday April 06, 2010 15:08:58
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