My 19 month old was just diagnosed a week ago with type 1. At what age would he be eligible for the pump?

There is no “right” answer to your question, just as there is no good answer to the question of who will ultimately succeed or fail on pump therapy.

First, especially with a newly diagnosed toddler, I’d make sure that you work on maximizing your knowledge and the way you’re using injected insulin. You should make sure that you know and understand how to count carbohydrates and use carbohydrate/insulin ratios and corrective doses. You need to understand how insulin works and how to trouble-shoot illnesses. You would need to ensure that his daycare or babysitting providers are also comfortable with calculating insulin doses and trouble-shooting when necessary, that they are able to check blood sugars and ketones. It has been my personal experience that families with children with diabetes generally need about a year of experience before they’re ready to “jump in” effectively to a pump life.

If you’ve done all that, his numbers are still erratic, and you’re still thinking about pumps, it’d be important to discuss your son’s diabetes with members of a health care team that can manage a very young child on a pump. This is because, just as the blood sugar target ranges are different for toddlers, the insulin requirements of very young children on pumps are very different than in older individuals. It has been our personal experience that pumps seem to work better in children who do not have very low daily basal insulin requirements.

A few centers, including ours, are doing controlled studies in pump therapy in very young children; some others are gradually gaining experience as pump therapy becomes more popular.

LAD