Study Proves Young Children Can Use Insulin Pumps Effectively, Safely
May 05, 2002
A study presented this week at the Pediatric Academic Societies' annual meeting in Baltimore offers proof that insulin pumps are a safe and effective alternative to shots for even the youngest of children. The study was conducted at Golisano Children's Hospital at Strong.
"These findings should encourage parents and pediatricians to support this technology, which has gained widespread acceptance in older populations," says Nicholas Jospe, M.D., a pediatric endocrinologist from Golisano Children's Hospital. "We recommend that parents of children who have diabetes at least start a discussion with their health care provider about the possible benefits of insulin pumps."
More than 800 children ages 3 months to 21 years who have diabetes are cared for at Golisano Children's Hospital, part of the University of Rochester Medical Center. Of that patient population, 180 use insulin pumps. Fifty-three of those children are younger than 13, a large sample size for this type of study. Researchers - led by lead author Jean Mack-Fogg, a pediatric nurse practitioner at Golisano Children's Hospital - found that, with only one or two exceptions, the younger children were very responsible wearing an insulin pump, alleviating concerns about their safety.
In addition, the authors confirmed that several advantages of the insulin pump, documented in older populations, hold true for children younger than 13. For instance, children experienced better control of their diabetes because they were able to more effectively manage their insulin levels, resulting in less erratic blood-glucose levels. In addition, blood sugars for children using pumps were closer to normal, and children experienced less severe low-blood sugar reactions than when getting shots.
Statistics from the American Diabetes Association indicate that some 17 million Americans have the disease. Nearly 800,000 new cases are diagnosed each year.
Diabetes is a disease that prevents one's body from properly using energy derived from food. In many cases, that's caused when the pancreas produces little or no insulin. Without proper levels of insulin, a hormone that helps transport glucose to the body's cells, the glucose levels in the blood rise, resulting in diabetes.
An insulin pump is a small, programmable device that provides an appropriate level of insulin throughout the day to a person who has diabetes. Although children still need to check blood sugar, closely calculate food intake in order to match insulin, and keep careful records, pumps replace two or three shots of insulin that would be otherwise required.
Nearly 20 years ago, pumps began to gain acceptance as a viable way of providing insulin to people who had diabetes. Although they were oversized and inconvenient, they've been mightily refined during the last two decades. "The electronics are better, they're smaller, and they're more durable today," Jospe says. "Insulin pumps are a popular option again for teens and adults."
For many years, teen-agers and adults have been encouraged by health care providers to use insulin pumps, and the benefits and safety were documented. Little information was available, however, about whether those benefits applied to younger children, and whether such young patients could safely use the technology.
"Pumps really were for older kids," Jospe says. "Everyone had an intrinsic fear that a younger child would play with the buttons on the pump and perhaps do something to change the instructions. People were afraid youngsters would end up in the hospital because they'd change their prescribed insulin levels."
The study was funded by a grant by Medtronic MiniMed Inc.