Insulin pump effective for infants, children

BALTIMORE With proper supervision, toddlers and preschool children with Type I diabetes can safely and successfully use an external insulin pump rather than multiple daily injections to treat their disease, according to a recent study by Duke University Medical Center researchers. However, the scientists emphasized that further research is necessary before treatment guidelines recommend widespread use of pumps by young children.

Insulin pumps are small beeper-sized machines that infuse programmed amounts of insulin into the body via a catheter placed through the skin. These pumps are sometimes used in adolescents and adults as an alternative to the traditional injection-based treatment of diabetes, but they are rarely used in young children. Typically, diabetes in infants and toddlers is treated with two to four injections of insulin daily. However, multiple insulin injections cannot always stabilize blood glucose, and young children are at high risk for episodes of severe hypoglycemia (low glucose levels). Severe hypoglycemia can, in some cases, result in coma, seizures, learning disabilities and behavioral disorders.

"In young children, food intake and physical activity levels are unpredictable, and it is difficult to administer very low doses of insulin precisely," said Michael Freemark, M.D., chief of the division of pediatric endocrinology and diabetes at Duke. "Moreover, the child is often unable to convey symptoms of low blood glucose to parents and caretakers. These factors make diabetic control exceedingly difficult in this age group and increase the risk of severe hypoglycemia."

Freemark is senior author of the study, which was presented today (May 6) at the 2002 Pediatric Academic Societies' Annual Meeting.

There has been considerable controversy concerning the use of insulin pumps by young children, Freemark said.

"Some suggest that the insulin pump is inappropriate for preschool children because they lack the kn

Contact: Richard Puff
Duke University Medical Center

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