Convenient Care: The Insulin Pump
Insulin pumps deliver a steady stream of insulin, which most closely mimics a natural state, experts say.
But while the insulin pump is for many people an improvement
over multiple daily injections, it requires a dedicated and savvy operator to
make it work. The user still has to perform multiple daily blood tests to check
for glucose levels, and must know how to program in the right insulin dose
after each test; currently available pumps can neither sense current glucose
levels nor can they automatically adjust insulin levels.
"It's just a different tool for delivering insulin; the
person still needs to input the doses, and to get the most out of the pump one
still has to be pretty knowledgeable and skilled in diabetes self-management.
It's not a tool for the novice," Wolpert says.
"It isn't right for everyone," agrees Michael Freemark,
MD, professor of pediatrics and chief of the endocrine and diabetes division at
Duke University Medical Center in Durham, N.C. "It requires a strongly
committed family and an experienced diabetes team."
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
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