USNews.com: Health: In Brief: Diabetes and Endocrine Disorders: Type I diabetes

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Saturday, July 5, 2008

Type I diabetes

An insulin pump can work for very young children

By Helen Fields

12/13/04

Insulin pumps have been around for almost 25 years, but until recently, they weren't often used for children with Type I diabetes. Researchers at Yale looked at children who used the pumps, which attach to the skin and are programmed to deliver insulin continually.

What the researchers wanted to know: What are the long-term benefits of an insulin pump for young children with Type I diabetes?

What they did: The researchers collected information on all of the children who'd been started on insulin pumps at the Yale Pediatric Diabetes Center when they were 6 years old or younger. There was enough information on 65 of the children to be useful. The researchers compared the children's experiences before and after getting the pump and through up to four years of follow-up visits.

What they found: The children's levels of glycosylated hemoglobin (HbA1c), a measure of how well diabetes is being controlled, fell after the pumps were started and stayed low through years of follow-up. Children under the age of three had the biggest improvement in HbA1c. The insulin pumps also decreased the frequency of severe hypoglycemic episodes. The researchers say that one concern about using insulin pumps in children is that they'll be too confusing for day-care providers, but they found that kids who got day care from someone other than their mothers actually improved more with the pumps than kids who were with Mom every day.

What the study means to you: Insulin pumps seem to be very helpful for young children—and should be more pleasant for both children and their parents than the alternative, which is giving several insulin shots a day.

Caveats: The children in this study weren't randomly chosen; they'd all been determined to be good candidates for pumps, based on the family's past success at keeping track of the child's diabetes. But in any case, the researchers say, this shows that you shouldn't rule out insulin pumps for children just because they're very young. Eleven of the children weren't even 3 yet when they started on the pumps.

Find out more: This encyclopedia article (www.nlm.nih.gov) on diabetes from the National Library of Medicine includes diagrams of insulin pumps

Medical device maker Medtronic makes an insulin pump and gives this explanation (www.minimed.com) of how they work.

Read the article: Weinzimer, S.A., et al. "Persistence of Benefits of Continuous Subcutaneous Insulin Infusion in Very Young Children With Type 1 Diabetes: A Follow-up Report." Pediatrics. December 2004, Vol. 114, No. 6, pp. 1601–1605.

Abstract online: http://pediatrics.aappublications.org

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