My daughter is 2 1/2 and was diagnosed at 13 months. The center we currently use does not believe in putting young children on pumps. I really like the center we are using. They believe that the older kids can better manage the pump, however I am constantly finding articles suggesting that putting a toddler on a pump can be a good thing. Any comments?

Insulin pumps are an excellent way to deliver insulin but require a lot of work and commitment in toddlers as well as anybody else with diabetes. They don’t work if you, as parents, don’t have an excellent understanding of how insulin works, what the limits of insulin therapy are, how to use blood glucose monitoring to provide information, how to analyze such information and how to carb count as well as balance changes in activity and sick days.

Insulin pump advertisements often give the mistaken impression that the rules of diabetes care can be relaxed when using a pump. While there is often more flexibility and especially more flexibility in delivering overnight insulin requirements using a pump vs. injections, usually a pump involves more work and care rather than less. Pumps are also expensive and sometimes scary for young children since you cannot explain using bigger needles (catheters) as easily to a toddler as to an older child, why the abdominal region is preferred etc.

Nevertheless, there are more younger children using pumps successfully all around the world in recent years with good results. It’s very important to have a close working relationship with experienced diabetes nurses, dietitians and physicians when using a pump so I would suggest going back to your diabetes team and continuing to have a conversation about why they are hesitant about using a pump.

Two excellent books are available from Minimed: The Insulin Pump Therapy Book and Teens Pumping It Up.

Hope these musings from a pediatrician who prescribes insulin pumps for toddlers is helpful.

SB