My nine and half year old son has had diabetes for three years. His last A1c test was 8.5. He is interested in the pump but his doctor does not put kids younger than 11 years old on the pump. I am concerned about the high A1c numbers and how that will affect his health later on. Is my son’s doctor’s concerns valid? Should I fight for him getting a pump?

An A1c of 8.5% is a little high but reasonable in a child of this age. Some research suggests that children are protected from the development of complications prior to puberty even with poor control and he is certainly not poorly controlled.

To start a pump, it is essential that you have the support of a your diabetes team. Without that support, it can and probably will be a disaster. Please also consider if your son wants to use a pump and if he is ready for one. The decision needs to rest with him. If he is ready and willing, ask your diabetes team to evaluate that readiness even though they don’t usually start kids at this age. You might change their minds.

Should you have the support of your diabetes team, you will still have a tough job yourself. Using a pump requires more monitoring and it is essential that your child trusts you and is willing to let you participate more in his care. It would not hurt to wait until he is old enough to take on the majority of responsibility for the pump.

SS

[Editor’s comment: If you and your son feel that the pump is the best choice for you, you should be able to persuade your son’s doctor. Contact both pump companies and get their pump literature. Talk with other parents and kids who use the pump (try the pump users chat room). Then, when you go back to your doctor, you will be prepared to address any concerns he might raise.

JSH]