Determining Whether an Insulin Pump Is Right for Your Child

Insulin pumps deliver insulin much like the body does, helping people with type 1 diabetes improve blood glucose control and avoid both hypoglycemic episodes and diabetic ketoacidosis.

Getting an insulin pump for your child may prove to be a wise choice, but there is plenty to consider before making that decision. You need to understand the basics of pump operation and how much of that operation is expected of the child’s caregivers.

Pump Basics

Insulin pumps, which are about the size of a pager, are attached to the body by a needle inserted beneath the skin. They can remain in one place for two or three days before needing to be moved and reinserted.

A pump delivers insulin two ways. It provides basal insulin, or short-acting (rapid) insulin continuously delivered through the needle, and they are programmed to give bolus doses (additional insulin) at meal and snack times. Older kids, or the parents of younger children, must test the child’s blood sugar level four to eight times each day to determine the pump’s efficiency, adjust mealtime boluses, and correct for high glucose readings.

It is easy to see why young children cannot manage pumps on their own, and that older children will need parental help. This means a knowledgeable caregiver must be available seven days a week, 24 hours each day to assist with blood sugar monitoring, to determine mealtime insulin doses, adjust the pump’s settings, and deal with any arising problems.

Things to Consider

Asking yourself and other family members the following questions can help you become clear about the suitability of an insulin pump for your child.

Is your child:

• willing to wear a pump, or willing to try?
• willing and able to tolerate the pump’s needle-insertion?

As the parent or other main caregiver, do you:

• have a good understanding of basal-bolus insulin therapy?
• know how to count carbohydrate or use a different insulin-to-food ratio?
• know how to correct for blood sugar highs or lows?
• know how to modify insulin doses for changes owed to exercise, travel, sick days, or other special events?
• know how to monitor for ketones and what to do if they are present?
• feel confident you can operate an insulin pump?
• have the time to manage your child’s diabetes every day?
• have working relationships with school personnel and other caregivers who are capable and willing to help with the pump?

Does your child's diabetes care team:

• include a physician, diabetes nurse educator, registered dietitian, a mental health counselor, and other health professionals?
• have experience with young patients using pumps?
• provide 24 hour phone contact for users of insulin pumps?

Consult Your Doctor

If after reading about pumps and considering the questions you are still interested in acquiring a pump for your child, it is time to talk to your health care team. They will help you clarify the advantages and disadvantages of a pump for your family’s situation, and maybe provide a pump that the child can wear a few days to see what it is like.

Source: Diabetes Spectrum
Photo credit: U.S. Dept. of Education