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February 22, 2001

Insulin Pumps

Question from Whittier, California, USA:

Our five year old was diagnosed with type 1 diabetes at nine months of age. Since that time he has done very well with no major hypo episodes or hospitalizations, and his hemoglobin A1c levels are consistently 6.5% to 7%, with the last three being 6.5%. He receives four shots per day of NPH and R and Humalog if needed. He is tested seven to ten times per day. His diabetes team has recommended that he go on the pump. I have some reservations, but we really want to do what is best for him in the long-term. Would there be an advantage to starting him on the pump at this time?

Answer:

It sounds like you are doing a great job. I would suggest that you talk to your diabetes team in some more detail, possibly scheduling a separate appointment without your son late in the afternoon or on a Saturday morning so that you and the team are not rushed. This would let you and them explore their recommendations. It is possible that they think you might get better day to day control with less variability even though the hemoglobin A1c values are doing so well. Perhaps they think there are too many episodes of hypoglycemia and the insulin pump might be a way to decrease these.

SB