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May 11, 2008

Insulin Pumps, Other

Question from Hoffman Estates, Illinois, USA:

I heard there was a study done in Seattle about teens and pump therapy in which a doctor found that using a pump is not the best for teens receiving insulin because of there different activity level and they go through puberty. How true is this? I have not found this article in our Chicago paper, but I heard about it through a friend at work. I am concerned for my son who has had diabetes for eight years and on a pump for six years.


I suspect you are referring to an Associated Press story which was included in many papers, including The Seattle Times (Insulin pumps linked to teen deaths). This AP news story reports on an article published in the journal Pediatrics entitled “Adolescent Use of Insulin and Patient-Controlled Analgesia Pump Technology: A 10-Year Food and Drug Administration Retrospective Study of Adverse Events” (abstract, HTML full text, PDF full text). The authors of this study reviewed 10 years of adverse event reports associated with insulin pumps used by young people ages 12 through 21.

Prior to the publication of the AP article, I spoke with Carla Johnson, the author. I shared our family’s very positive experience with insulin pump therapy, explained the enormous benefits in quality of life that come irrespective of improvements in glucose control, and I described the enormous amount of scientific literature which has looked at insulin pumps and found their use to be beneficial. I spoke about the general challenges of being a teen and succeeding with type 1 diabetes, regardless of insulin regimen, and of the importance of continued parental involvement, which was also specifically mentioned by the authors of the Pediatrics paper. I also called attention to the serious limitations of the study, which were described in considerable detail by the authors. Unfortunately, Johnson chose draw a conclusion that insulin pumps are dangerous, which, as a blanket statement, is not supported by the evidence presented in the paper, due to the limitations mentioned (incomplete reports, no sales or use data to determine incidence rates, accuracy and completeness of reports were not verified, no data on patient particulars).

As a parent of a child with diabetes who uses an insulin pump, I always recommend remaining involved in your child’s care and I would suggest working with your diabetes team to review pump therapy periodically or as your child’s situation changes (e.g., joining a new sports team).

For more responses to the AP article, see:

Pumps Are Good, M’Kay?
In Defense of Insulin Pumps?
More Damaging Headlines: the FDA Disses Insulin Pumps