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December 6, 2000

Insulin Pumps

Question from Easton, Maryland, USA:

My 12 year old daughter was diagnosed with type 1 diabetes two months ago. We have been working with our local pediatrician on managing her diabetes, but are going to our first appointment at a diabetes clinic next week. After talking with several parents of children on pumps, we are all very interested in the pump. We think she is definitely in the honeymoon stage, as her sugars have been mostly in the normal range for about three weeks. I am anticipating that this clinic is not particularly "pro-pump" and just started using pumps on children earlier this year. We have been told that the clinic would probably want to follow her diabetes for about a year before recommending the pump. Is this the practice norm? Does she need to be out of the honeymoon period before going on a pump? I would like to have as much information as possible for our initial visit. By the way, I have two other options for clinics, but both have much longer waiting lists -- one about 9 months long.

Answer:

The most important issue remains controlling the blood sugar levels and working with knowledgeable diabetes teams — knowledgeable about children, teenagers and family issues. Once you meet with this new team, you will have a better sense of whether they are the right ones for you and your family. Using an insulin pump during the honeymoon phase of type 1 diabetes does not add very much benefit so that some extra waiting time while everyone gets to know one another is not necessarily so bad. You may want to place your name on the waiting list for the other two diabetes clinics now so that you can have this as another option to pursue — just in case.

SB