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Question:

From Weyburn, Saskatchewan, Canada:

My 18 year old son has been insulin dependant for six years now, he is not compliant and will only take his insulin or check his blood sugars when forced to do so. He also has behavioral disorders and is noncompliant with those medications. He is no longer living at home, and in the last four months, he has been hospitalized three times for DKA. The last time was the worst as his blood sugar level reached 723 mg/dl [40.2 mmol/L] when he was admitted, and he was in serious trouble with tachycardia. He is living in the USA now with friends, and I live in Canada. Our doctor here in Canada thinks he is a good candidate for an insulin pump because he is in such poor control. Everything I have read indicates that this is a bad choice. My son wants the pump only because he thinks he then will not have to do anything and will be able to eat anything he wants. Is the pump a good choice for him?

Answer:

Insulin pumps generally require some work and commitment to gain their benefits, and they are somewhat expensive. However, there are a few studies that suggest that the most noncompliant patients with diabetes sometimes do better on an insulin pump assuming that they will wear it and at least get their basal insulin more often than what they are omitting by shots. If that is the case, then your son may deserve a trial with a pump.

Your son's risk of dying during one of his DKA [diabetic ketoacidosis] episodes is very high if he waits too long to go to the emergency room or get insulin. Sadly, if he does not die while omitting his insulin, then one of the long term complications of diabetes (retinopathy, nephropathy, neuropathy, heart attack, hypertension or some combination) is likely going to occur unless his decision to not take care of himself can be reversed.

I would suggest that you speak with your son's diabetes team and see what they think.

SB

[Editor's comment: In my opinion, your son would be very poor candidate for a pump. See Is pumping for you? SS]

DTQ-20011215091105
Original posting 17 Dec 2001
Posted to Insulin Pumps

  
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Last Updated: Tuesday April 06, 2010 15:09:30
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