Insulin pump therapy may be a safe and effective treatment for children under age seven with type 1 diabetes (search), according to a new study.
Researchers say the results suggest the insulin pump (search) may ease the burden of periodic insulin shots for many parents, including those who also rely on a nanny or day care worker to care for their child part of the day.
In type 1 diabetes, the body cannot produce insulin in order to maintain healthy blood sugar levels (search). Children with type 1 diabetes must receive frequent injections of insulin to keep their blood sugar levels under control.
Although insulin pumps that supply a continuous dose of insulin to the body have been used for several years in adults and older children with type 1 diabetes, researchers say this is among the first studies to look at their use in very young children.
The results of the study appear in the December issue of Pediatrics.
Insulin Pump Safe for Young Children
In the study, researchers looked at the safety and effectiveness of insulin pump therapy in 65 children with type 1 diabetes between the ages of one and 7.
About 60 percent of the children were cared for by their mothers during the day, and the remaining 40 percent were cared for by paid caregivers either in the home or at a child care center.
The study showed that average blood sugar levels (as measured by HbA1c levels) decreased after one year of insulin pump use and continued to improve after the next four years of insulin pump use. Use of the insulin pump was also associated with a more than 50 percent reduction in the incidence of low blood sugars.
In addition, children who received daytime care from paid caregivers showed an even greater improvement in blood sugar levels than those who were cared for by their mothers.
“This report is the first to show that insulin pump use may be implemented successfully in very young children whose daytime care is provided by paid caregivers, such as nannies or child care center workers,” write researcher Stuart A. Weinzimer, MD, of the Yale University School of Medicine, and colleagues.
Researchers say that when necessary these caregivers may be taught the basics of insulin pump use, such as ensuring proper function of the pump, attending to the alarms, and how to provide meal-related information to determine insulin doses.
They say the study shows that insulin pump therapy is not only effective in treating young children, but it also may be superior to multiple daily injections in minimizing episodes of severe low blood sugar.
By Jennifer Warner, reviewed by Brunilda Nazario, MD
SOURCE: Weinzimer, S. Pediatrics, December 2004; vol 114: pp 1601-1605.
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