Children and Insulin Pumps

The guidance produced by the organisation NICE (see 'pump websites and support' page) gives greater support to insulin pump use in children than adults, in that it can be used for children under 12 years of age if multiple injection therapy 'is considered to be impractical or inappropriate' - thereby by-passing the need for a trial of multiple injections. However, it also states that in these circumstances, multiple injection therapy should be tried between the ages of 12 and 18.

It can be difficult to decide if your child should have an insulin pump, or, if you are a young person yourself, whether it is for you. Pumps have had great success when used with very young children, as insulin doses can be adjusted much more easily to deal with unpredictable eating patterns, and in teenagers, the hormone changes, rapid growth and sexual development that make diabetes difficult to control can be managed more successfully with such a flexible system. They have also been successful in children and young people who experience a lot of night-time hypos, and have reduced the large swings that some people regularly experience between high and low blood glucose levels.

In terms of lifestyle, pumps help children fit in much more easily with their peers. They find they are no longer singled out to 'go and have their medication' from the teacher's office, or having to go to a private room to do their injection - instead, they can meet their daytime insulin needs by simply programming their pump as they go. Eating away from home and dealing with variable and unpredictable physical activity also all become easier.

For children using a pump, there are many similarities with adult pump use, although setting basal rates and bolus amounts can require more attention, simply because of the smaller amounts of insulin involved. Whilst that is no different from managing childhood diabetes with injection therapy, in many cases it can be easier because of the very small doses that insulin pumps can provide - for example with some pumps, hourly basal rates can be set as low as 0.01 unit per hour.

What is important when using pumps in children and young people is that families work together, and that everyone concerned is clear about what the pump will mean and that they all agree it is the right course of action, rather than, for example, parents wanting a pump but their child being resistant to the idea.