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Convenient Care: The Insulin Pump

Insulin pumps deliver a steady stream of insulin, which most closely mimics a natural state, experts say.

You're Never Too Young...

Yet with the right supervision and support from dedicated caregivers, even infants or toddlers with type 1 diabetes can benefit from the use of insulin pumps, Freemark tells WebMD.

"If you have a very conscientious, careful, reliable family who's willing to monitor the use of the pump closely, I think in many ways that pump therapy is more effective in very young children than it is in teenagers who are out on their own and entirely responsible for their care independent of their parents," he says.

Freemark and colleagues performed a small pilot study of insulin pumps in young children, and found that the pumps reduced the number of episodes of severe hypoglycemia (abnormally low blood sugar) by a factor of five compared with insulin injections. The parents, when interviewed by the researchers, expressed greater confidence in their ability to manage their children's diabetes and a general improvement in the family's quality of life.

Insulin pumps may be particularly beneficial for children because their unpredictable food intake and energy expenditure make it difficult for parents to judge how much insulin they should give by injection ahead of time. In addition, because their small bodies require only fractions of adult insulin doses, "it's almost impossible to do it accurately through injections. I would venture to say that it isn't possible to administer quarter of half units of insulin accurately by insulin syringes," Freemark says.

Insulin pumps also are far less likely to cause episodes of severe hypoglycemia because they release insulin in a steady dose rather than in a major bolus, he adds.

"To my amazement, we have had no trouble with the children themselves," Freemark tells WebMD." We haven't limited their activities and they still do somersaults on the ground and wrestle with their brothers and sisters, but we haven't had the problem I was most worried about when we started, which was that the kid was going to pull the pump out, and play with it, and push the buttons - we've had none of that."

...Or Too Old

On the other end of the spectrum, many seniors with type 1 diabetes can also benefit from the use of an insulin pump. According to an American Diabetes Association publication, many seniors who use the pump report better control of complications, improved vision, better sleep, and relief from anxiety about hypoglycemia.

Insulin pumps cost several thousand dollars, but Medicare now covers the cost of pumps for many seniors, and other insurance plans also pick up some or all of the cost for their patients with diabetes, Freemark notes.

Reviewed on November 20, 2006

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