My 15 year old son has sky high blood sugars in the mornings, known as the dawn phenomenon. My husband and I are considering the insulin pump as an option since my friend’s daughter was successful at getting one recently, but my son’s paediatrician is reluctant to prescribe it. Are there specific criteria for issuing the insulin pump? Why is the United Kingdom so backward compared to other countries on the insulin pump? It’s very frustrating, as I know it could improve my son’s quality of life and greatly reduce the risk of developing complications.

Sorry to say, but the UK diabetologists are not backward. You should have a more detailed conversation with your son’s diabetes health care team to find out what options are available, whether or not an insulin pump is a reasonable treatment option compared to say, multiple insulin injections with bedtime NPH or Lantus (insulin glargine), etc.

There are many ways to control blood glucose levels including the dawn phenomenon. Insulin pumps are an excellent way but costly and require much input on the part of health care team as well as parent and child/teen. You may want to visit our pump section and perhaps read Teens Pumping It Up: Insulin Pump Therapy Guide for Adolescents by Elizabeth Boland, MSN, APRN, PNP, CDE. This will give you wise information and food for thought to present to your diabetes care team — and allow you to make more realistic assessment of the pros and cons of insulin pump therapy. So begin a more detailed dialogue so that you can come up with some reasonable choices.

SB