We are looking into getting a pump for our six-year-old son. His doctor recommends the Animas pump for all of his patients under 10 years old. A friend of my son uses the Animas pump and the family is happy with it, so I know it’s a good pump. I also like that it gives you the smallest doses of insulin than any other pump since my son still requires low doses occasionally. But, I’m also interested in the continuous glucose sensor that MiniMmed offers and would love to take advantage of that technology when it’s available for my son. So, I’m confused as to which pump I should get. I hate to get the Animas and then want to switch in a year or so because I want the sensor capability. What is your suggestion for people now who are interested in the pump? Is it worth choosing the MiniMed or will they all offer sensors in the near future?

I may be old-fashioned, but I have not yet recommended that my pediatric patients investigate pump options based upon the availability of continuous glucose monitoring technology. Right now, you can buy (note: insurance will NOT cover costs) three types of continuous glucose monitors. These include a Medtronic monitor that is free-standing from the pump, one from Medtronic that is integrated into the MiniMed pumps, and a free-standing one from DexCom. They run about $1000 for the set-up and a month of supplies (the integrated one is a bit cheaper) and then, currently, about $30 every three days for the sensor. All sensors need to be calibrated throughout the day to fingerstick blood sugars, and are not yet at the accuracy level where they can be relied upon for more than “trends” in glucose patterns. In particular, they are not to be relied on for sensing HYPOglycemia. More sensors are on the way from other companies. Probably these too will be integrated into pumps.

The reason I have hesitated to recommend these sensors (or getting a Medtronic pump solely because it offers the sensor now) is that I think the utility of these sensors for children remains to be explored carefully. Very few diabetes clinics download pumps; I am not certain how many will be able to extract meaningful information from sensors and how the data will be used to adjust insulin. I also don’t yet know how children and parents will use the fine detail of the swings in blood sugars to adapt insulin regimens appropriately.

For now, I would recommend looking at the available pumps and the advantages/disadvantages of each and choosing a pump based upon other available features.

LAD

[Editor’s comment: In addition to the above mentioned pumps, you should investigate the OmniPod insulin delivery system.

BH]