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December 26, 2000

Insulin Pumps, Social Issues: Insurance/Costs

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Question from Walden, Colorado, USA:

Our nine year old daughter was diagnosed at the age of three. We are headed into a second level appeal with our insurance company over a denial of request for an insulin pump. She is on pork insulin and Humalog. Her numbers have been as low as 12 mg/dl [0.7 mmol/l] (never had a reaction) and as high as 600+ mg/dl [33.3 mmol/L]. Her HbA1c hovers between 11 and 13%. She is on only two shots per day. We live an extremely remote area, she’s the only student in the school district with diabetes, and we do not have a school nurse at the school (we use the county nurse for school situations, but she is not always there). The appeal hearing yesterday ended with a letter written to us (which we received today) that states, in part: “The committee decision to deny your request was made based on the fact that use of an insulin pump on a person of your daughter’s age is not well established in the medical community. In addition, medical literature review does not support the use of an insulin pump in this age group.”

My husband and I have decided to go on with the next appeal. What we are searching for is the documentation on the use and benefits of insulin pumps for children her age. Anything would be greatly appreciated!

Answer:

From: DTeam Staff

The only published article that I know was in Diabetes Care sometime last year. Dr. Fran Kaufman and her group demonstrated improvement in control with over night use of the insulin pump. Even though many pediatric endocrinologists are using the pump successfully in this age group, all the other information I know of is anecdotal and not published.

SS