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April 29, 2001

Insulin Analogs, Insulin Pumps

Question from Binghamton, New York, USA

My nine year old daughter was diagnosed with type 1 diabetes a year ago, and we have been working toward putting her on the pump (we even switched doctors to do this). My daughter is very athletic and in many sports year round.We thought the pump would be the best for her, but her new doctor says she would do better on Lantus (insulin glargine), and Humalog because she is athletic. What are your thoughts on this?

ANSWER:

The question doe not appear to be control since it sounds like you have made that commitment. Athletics do pose some problems with insulin pumps. Sometimes we have to disconnect from time to time especially with certain contact sports. It isn't insurmountable, but it is a problem. The use of a basal insulin [such as glargine] with multiple doses of Humalog is attractive, and maybe even worth a try. I think it is reasonable to think about. Since you and your daughter have to make the ultimate decision, perhaps she should wear a pump for a week or so with saline and give it a try with the sports you play to see which ones will demand a disconnect time. In the meantime, an intensive multiple dose regimen could be tried to see which is more trouble, etc. There is no right answer, just what works best for your daughter. LD