Kids and Pumping: Lessons Learned Over the Past 5 Years

Supported by an educational grant from Smiths Medical MD, Inc.

Wed August 11, 2004
12:30 – 2:30 PM

Program Faculty:
Jo Ann Ahern, APRN, MSN, CDE
Mark W. Parker, MD, FAAP
Richard R. Rubin, PhD, CDE

Reviewed by Joelle Escoffery, PhD

Insulin pump use, particularly among younger children, is becoming increasingly popular. Pump use offers many advantages over syringe injections, including fewer injections, more predictable and accurate insulin delivery, increased flexibility, and reduction of hypoglycemia. A recent study demonstrated that pump use among children resulted in improvements in glycemic control and decreases in hypoglycemia, as compared with multiple daily injections. There are a variety of reasons why a child should be placed on an insulin pump, including problems with nocturnal hypoglycemia, an erratic schedule, or participation in sports.  However, one very important reason to consider pump use is if the child and family are motivated to have the child use a pump. Indicators of pump success include good metabolic control, good self-care adherence, ability to successfully count carbohydrates, and family support. When starting a child on a pump, there are a variety of formulas that can be used to determine basal insulin rate, bolus amounts, and correction factors, although many physicians rely on their clinical experience to alter these formulas. Recent advances in insulin pump technology have simplified the use of pumps.  New “smart pumps” will create a total carbohydrate intake based on amount of carbohydrates in individual food items entered, making it no longer necessary for users to total their own carbohydrate intake. Further, blood glucose data can be entered, and the pump with suggest a bolus amount based on total calculated carbohydrate intake and blood glucose level. Some pumps may also allow for the calculation of more than one correction factor, so that users can account for individual differences in insulin sensitivity. As pump technology continues to improve, it is predicted that pumps will continue to grow in popularity.