January 29, 2000
Question from a nurse in Kankakee, Illinois, USA:
My 8 year old son was diagnosed about 15 months ago with type 1 diabetes. He is on NPH/Humalog in the A.M., Humalog at supper, and NPH at bedtime. After meeting Nicole Johnson (Miss America 1999) and hearing about the pump, I’m very interested in having my son use a pump. His doctors state that they usually don’t consider them until late teens. How can I get them to consider one? I’m also a RN and willing to try it, and don’t want to change doctors. His HbA1c was 7.1!
Many pediatric endocrinologists still aren’t convinced that the insulin pump is appropriate for a young child, though in the past year with all the publicity from Miss America wearing the pump, it has become more popular. Also, many physicians don’t have the necessary resources or backup to train pump patients and don’t have someone knowledgeable with pump therapy available for backup 24 hours a day.
First, I suggest your family decide whether or not you think the pump would be appropriate for your child and what you hope to get out of the pump.You should also discuss these issues with your child’s physician. Pump therapy is not an artificial pancreas. It doesn’t guarantee “perfect control”, and although it certainly can provide more flexibility and probably improved control for many individuals (including young children), it also has drawbacks and dangers. We’ve discussed the pros and cons of pump therapy several times at this website and you might want to refer to a previous question and answer for more details.
If your family is convinced that they want to start pump therapy and your doctor is still uncomfortable with this or can’t provide the necessary support, you may want to ask your doctor for a referral to someone with experience with pump therapy in young children.
Additional comments from Jeff Hitchcock, The Editor:
You may want to visit Kids R Pumping, a web site about kids on pumps, and the Insulin Pumpers web site to learn more about pumps. Also, the parents’ chat room is a great place to learn from ther parents who have young kids on pumps.