Our five year old son has type 1 diabetes, and we have a very hard time controlling his blood sugars. Would he be better off on the insulin pump instead of doing insulin shot three times a day? Is he old enough for the pump? When is a good age to start with the pump? When is the insulin inhaler going to be available?

Inhaled insulin (at the Diabetes Monitor) is still in clinical trials so most likely two or three years away from availability. The biggest problem with inhaled insulin is lack of a very good basal insulin to provide background and through the night insulinization. New insulin analogs currently being tested may solve this problem in the coming years.

An insulin pump is an excellent, but much more involved, way to delivery insulin. It can and has been used in small children and infants, but requires a coordinated diabetes health care team with experience in using pump treatment. You should discuss this directly with your diabetes health care team since they know you and your child from a diabetes perspective, can assess your and your son’s abilities and also know about hemoglobin A1c results you are currently achieving as well as day-to-day glucose variability.

Insulin-Dependent Diabetes in Children, Adolescents and Adults by Ragnar Hanas has some excellent information about insulin pump treatment. You also can visit the MiniMed, Disetronic, and Animas websites for specific information about currently available pumps. There is also a Chat Room at this website about insulin pump treatment from parental perspective as well as child perspective.

SB