Young kids with diabetes do well with insulin pump

For preschool-age children with type 1 diabetes, using a continuous subcutaneous pump to deliver insulin is a "safe, effective and superior" alternative to twice-daily insulin injections, according to a new study. Insulin pumps have been used successfully by adults, adolescents and school children, Dr. Tseghai Berhe from Loyola University Medical Center in Maywood, Illinois and colleagues note in their report, but pumps haven't been used widely for preschool-age children.
This is "presumably because of the fear of hypoglycemia (excessively low blood sugar levels) and concerns that young children are too immature and may meddle with the insulin pump," the team writes in the medical journal Pediatrics.
They reviewed the charts over a two-year period of 33 children with type 1 diabetes who switched to insulin pumps therapy from a twice-daily insulin injection regimen. The kids were between 2 and 7 years old.
Insulin pump therapy led to a "significant improvement" in overall blood sugar control, significantly fewer episodes of excessively low blood sugar levels, and fewer sick days, Berhe told Reuters Health.
The team saw less variability in the young children's blood sugar levels when they were on the insulin pump group, "which could be beneficial since they are at an increased risk of neurodevelopmental impairment from uncontrolled blood sugar levels -- from both low and high blood sugar levels," Berhe explained.
Although significant weight gain has been associated with insulin pump therapy in previous studies, "our patients showed little difference in BMI (body mass index, a measure of weight in relation to height) or amount of carbohydrates consumed," Berhe added.
Additionally, the investigators found no evidence that the young children interfered with the pump system.
The researchers conclude that "preschool-aged children receiving care from an actively involved diabetes team with a supportive family can experience improvements in diabetes control with current insulin pump therapy."
There's a good possibility, Berhe said, that "initiating insulin pump therapy at a very young age may also lead to prevention of long term complications of diabetes."
SOURCE: Pediatrics, June 2006.