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August 1, 1999

Insulin Pumps

Question from Tokyo, Japan:

We have a nine year old son with Type 1 diabetes. We are considering an insulin pump. We've read that pumps are used by some children and that excellent parental support is required. What else can you tell us regarding the pros and cons of using a pump for a young child? What additional issues would we have as pump users in Japan (I don't think they are very popular here)?

Answer:

The decision to use a pump for child of this age rests with him. Make sure that he is capable of using it and wants to.

I don’t know what resources are available to you in Japan, but it is essential that you have the support of a diabetes team experienced in the use of pumps in kids. Should you have that support, you will still have a tough job yourself. Using a pump requires more monitoring and it is essential that your child trusts you and is willing to let you participate more in his care.

Last, but not least, if his blood sugars are under control (based on the glycohemoglobin test), why change treatment regimens? If it is, I would wait until he is old enough to take on the majority of responsibility for the pump.

SS

[Editor’s comment: Many people feel that the lifestyle improvements associated with using a pump are as important as improved blood sugar control. With a pump, kids (and adults) are no longer tied to eating based on injected long-acting insulin. This means much greater freedom to eat when you want, and it also means that you can sleep late. But wearing a pump means just that–you’re always wearing an external mechanical device. Some activities, such as sports, require a little more thought, but there is nothing you cannot do because of an insulin pump.

JSH]