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Diabetes Bites Newsletter

Pediatric Insulin Pump Use: To pump or not to pump? Kids edition

As pump therapy becomes more common for people with type 1 diabetes more of us are starting on pumps earlier and earlier, including pediatric patients. Many parents struggle with making a decision about what is the right method of treatment for their kids.

A recent German study of over 30,000 participants under the age of 20 found that patients using pump therapy were 4.42% less likely to have an episode of severe hypoglycemia. This is not terribly surprising as pump therapy is often recommended for patients with a history of hypoglycemia. However the study also showed a slight decrease in episodes of Diabetic Ketoacidosis (DKA) as well. This may be because children on injection therapy often end up with chronically elevated blood sugars because the inability to microdose insulin leaves their care givers unable to give a correction of bolus dose large enough to correct, but small enough to avoid hypoglycemia.

This is one MAJOR benefit to pump therapy for kids. Today’s pumps allow dosing to the 0.025 units of insulin.  When a child has an insulin sensitivity of over 200 mg/dl ( 11.0 mmol/ml) correcting for any blood sugar under 300 becomes risky with a syringe.  A1C was, on average 0.2 lower and total daily insulin dose was also lower on average. Slow infusion speed and microdosing capabilities are ideally suited to a child’s anatomy and physiology. This allows insulin to be more effective at smaller doses, and to more closely match the insulin needs of both diet and activity levels of childhood. Children’s bodies are also constantly growing and changing, making the flexibility and quick changes of pump settings a great match.

The Bottom Line:
This data seems to make pump therapy an obvious choice, but diabetes management is never quite that simple. Some children do not tolerate a pump well, feeling it is obtrusive, or otherwise inhibits them. Pumps also take a level of education and management that may not be right for every family.  There is also the question of selecting the right pump and accompanying technologies to fit the child and family’s needs.

This is exactly where the services and expertise of Integrated Diabetes Services shine. Our experienced educators work with families and kids to teach them not only how to find the right settings to reach blood glucose control goals, but also how to maximize pump features and flexibility to live their best life, without diabetes being in the way.  This is a complex puzzle that not every diabetes clinic or practice is designed to handle, or skilled in teaching.  We encourage families seeking assistance, guidance and empowerment in their child’s diabetes management to contact us for a consultation, whether pump therapy or injections are the right fit for your child. 

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