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February 7, 2007

Insulin Pumps, Other

Question from Florida, USA:

What are the recommended guidelines for the appropriate age for a child to change his or her own infusion site?


From: DTeam Staff

Every child and situation is different, so there is no one answer to this great question. I would refer you to the wonderful book, Understanding Insulin-Dependent Diabetes by H. Peter Chase, MD. In particular, you should read Chapter 18, Responsibilities of Children at Different Ages. (You must have Adobe Acrobat Reader 7.0 or better to read this.)

As you will read in this chapter, although a child CAN change an infusion set at a certain age, it doesn’t mean they can be responsible to do the task safely, reliably, and consistently over time. It is a delicate balance to raise a child with diabetes keeping in mind the support, responsibility, and independence issues. The dilemma for all parents is: How do I help my child enough, but not too much, foster independence, but let them do all the normal rebellion and kid things? Just when you think you have figured it out, they want more or less help and may not be able to say it to you! Looking at the diabetes care as a team seems to work best. There may be times when you are more involved or less involved, and learning to be flexible and read the subtle signs sure helps.

I will give you one other point based on my experience: when talking to health care providers that do not have extensive experience with children with diabetes, I have sometimes found that may they recommend independence earlier than the pediatric diabetes experts. We can all be proud that a young child can do the task, but there is so much more than the ability to perform a task.