Juvenile Diabetes Kids Like Insulin Pump

Insulin Pump as Safe, Effective as Multiple Daily Injections

From the WebMD Archives

Sept. 10, 2003 -- Kids with type 1 diabetes like insulin pumps better than insulin shots, a new study suggests.

That's not news to parents. Ellen H. Ullman of Boca Raton, Fla., has a son with type 1 diabetes.

"How many shots a day would you like?" Ullman asks WebMD. "Well, kids don't like shots any better than you do. My son is 15 and has been pumping since he was 7. He's loved it and his blood sugars have never been better."

Today's insulin pumps are about the size of an electronic pager. They're programmed to infuse insulin continuously into the body through a thin needle placed under the skin. Some day, the pumps may be part of a system that senses when the body needs insulin and automatically delivers the exact dose needed. Now, pump users have to calibrate the machines by doing several finger-prick blood-sugar tests every day.

They are available for adults and sometimes used in teens. But doctors have been reluctant to recommend them for younger children.

That soon may change. Several important studies have already shown that with proper supervision, the pumps can work in kids. Now a small clinical trial shows they work as well -- and as safely -- as multiple daily injections in 9- to 14-year-old kids. What's more, kids prefer the pump to the shots.

The Latest Study

Naomi Weintrob, MD, and colleagues at Tel Aviv University in Israel randomly assigned 23 children to get multiple daily insulin injections or an insulin pump (the MiniMed 508, made by Medtronic. Medtronic is a WebMD sponsor). After three and a half months, they switched to the other regimen.

There were no significant differences in blood-sugar control or safety between the two regimens. When using the pump, kids tended to need less insulin, Weintrob and colleagues report in the September issue of the journal Pediatrics.

"The patients seemed to be more satisfied with pump therapy than multiple-daily-injection therapy," they write. "Be that as it may, satisfaction with pump therapy needs to be evaluated for longer periods, when the novelty of the pump is no longer a factor."

Weintrob's study looked at early adolescents. But Ullman says that far younger children do much better on the pump than they did when getting multiple injections.

Doctors have wondered whether very young children -- preschoolers, for example -- have the maturity to use the pump effectively and safely. Recent studies suggest that they can. And that's going to lead to more widespread use of the pumps among children, says Kim Hunter-Schaedle, PhD, director of industry relations for Juvenile Diabetes Research Foundation International.

"A lot of this is driven by patient demand," Hunter-Schaedle tells WebMD. "There will always be an element of personal choice. But with doctors, they will respond to the drive from the diabetes community. And studies like this will help. When pediatricians read this, they will say, "I've always been interested in whether the insulin pump can work in children. Now there is scientific evidence to show this."

Weintrob's study was supported by MiniMed, manufacturer of one brand of insulin pump. Ullman's web site accepts no financial support from insulin pump manufacturers.

Show Sources

SOURCES: Weintrob, N. Pediatrics, September 2003; vol 112: pp 559-564. Ellen H. Ullman, Boca Raton, Fla. Kim Hunter-Schaedle, PhD, director of industry relations, Juvenile Diabetes Research Foundation International.
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