My son was diagnosed with diabetes at the age of 10. He is now 14 years old and has never had regulated sugar levels. We have the pump but his doctor refuses to put him on it until he becomes regulated. I have always been under the understanding that this is a reason to go on the pump. What if we just went ahead and did it? We have had the diabetes education. His sugars go from 40 to 600 sometimes within just a few hours!

It’s hard to answer your questions about pump use in teenagers without knowing a great deal more about your son. I would suggest that you schedule a conference meeting with your diabetes specialist and the diabetes team — perhaps without your son first — to see what their concerns are.

Is it possible that the team does not have much experience using a pump and this is the reason that they seem hesitant? Are they concerned about whether or not your son is mature enough to use a pump responsibly? If so, they should be willing to discuss this with you on the phone or perhaps in person at such a conference.

You are correct that a pump should help improve overall control but only in those who understand carb counting and use it well, understand how activity helps but sometimes interferes with glucose control, are testing four or five times each day and keeping records, analyzing results, etc. If any of these areas is less than ideal, perhaps this is the source of their hesitancy. In any case, broaching the subject in a neutral fashion should give you some insight into where the barriers are from their perspective.

Hope these ideas are helpful since the pump is not magic, only a better way to be more physiologic with insulin delivery.

SB