My 12 year old son, who has had type 1 diabetes for the past two years, is unable to feel lows throughout the night which has resulted in three seizures. He is extremely active in sports, and we usually compensate for this activity by giving an extra starch at bedtime. At the present time, I check his blood sugar before I go to bed and usually twice throughout the night. We are considering whether to go on a pump. Would a pump help with stabilizing his blood sugars through the night?

While the insulin pump is most likely the best way to stabilize blood glucose control because of its extreme flexibility and the ability to fine tune things, it is not a panacea. The pump, in and of itself, will only provide this type of control when told what to do.

It seems to me that your first step would be to do some investigating on your own to find out what’s going on. This will require checking blood sugars every hour or two throughout a few 24-hour periods, including at least one day when your son has been quite active. You can then look for overall patterns and adjust his insulin regimen appropriately. Your son’s situation might more easily be clarified by monitoring sugar levels continuously for several days to try to sort out what’s happening in more detail. See The Continuous Glucose Monitoring System and ask if it’s available.

Without knowing what insulin regimen your son is on, I cannot make specific recommendations. Hopefully, he is using a basal/bolus program, and you are adept at carbohydrate counting along with appropriate insulin adjustments for highs and lows. These skills will be necessary as well to make the most effective use of an insulin pump.

A pump is a great idea, but not a solution to your son’s problem. However, it might make things more flexible provided you and he have appropriate training. To help with your decision, please see Is pumping for you? and ask your son’s diabetes team about all options.

SS