Is an Insulin Pump Right for Your Child and Family?
Insulin pump therapy can help people with type 1 diabetes. Pumps deliver insulin in a way that resembles the body’s own release of insulin. They can improve blood sugar control, make low blood sugar (hypoglycemia) less of a problem, and lessen the risk of diabetic ketoacidosis. But pump use in children, especially very young children, is controversial. If you are considering an insulin pump for your child, read on.
How Pumps Work
Insulin pumps are about the size of a pager. They are attached to the body by a needle placed under the skin. They can remain in place for 2–3 days at a time. Pump therapy delivers rapid- or short-acting insulin continuously through the needle. The continuous insulin is called the basal rate.
In addition to providing basal insulin throughout the day, pumps are programmed to give additional insulin (bolus doses) with each meal and snack. Older children or the parents of younger children must test the blood sugar four to eight times a day to check the pump’s effectiveness, adjust mealtime boluses, and correct high blood sugar levels.
So What’s Not to Like?
Pumps can improve diabetes control and give children more flexibility, but very young children cannot manage their own pump use. Even older kids need a good deal of help from parents. Therefore, pump therapy requires a knowledgeable parent or caregiver to be on hand 24 hours a day, 7 days a week to help with blood sugar tests, determine mealtime insulin needs, adjust pump settings, and troubleshoot any problems.
Consider These Questions
Is your child
• willing to wear the pump?
• able to tolerate the needle-insertion process?
As your child’s main caregiver, do you
• fully understand basal-bolus insulin therapy?
• know how to count carbohydrate or use some other insulin-to-food ratio?
• know how to correct for high or low blood sugar levels?
• know how to change insulin doses for changes in exercise, sick days, travel, or other special situations?
• understand how to measure ketones and what to do if they are present?
• feel sure that you can operate an insulin pump?
• have the time to care for your child’s diabetes every day?
• have partnerships with school personnel and other caregivers who are willing and able to work with a pump?
Does your diabetes care team
• include a doctor, a diabetes nurse educator, a registered dietitian, a mental health professional, and other health care professionals?
• have experience using insulin pumps with young children?
• offer 24-hour telephone contact for patients who use insulin pumps?
Good. Pump therapy may be a good fit for your child and family. Before making a final decision, sit down with your child’s diabetes health care providers. Weigh the pros and cons for your own family situation. Consider wearing a pump yourself and having your child wear one for a few days to see what it’s like. Find out all you can so that you and your child can make an informed choice.
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- American Diabetes Association