Diabetes and Your Child: Considering an Insulin Pump

An insulin pump is a small device. It's about the size of a cell phone. Insulin is sent from the pump to the body through a thin plastic tube. The tube is attached to a soft, flexible tube called a cannula. The cannula is put under the skin.

The pump can give a steady dose of insulin. This is called a basal dose. It acts like the body’s natural release of insulin. The pump can also give a single dose. This can be given before meals. Or it can be done to correct high blood sugar. This is called a bolus dose.

The pump is worn all the time, day and night. It is easily hidden under loose clothing. Or it can be clipped to a waistband or belt. But it can be disconnected for a short time for taking a bath or shower.

Some of the benefits of an insulin pump include:

• It reduces the number of shots needed (good if your child is afraid of needles).

• Doses of insulin can be given more accurately than with shots.

• It acts more like the body’s natural release of insulin than shots.

• It allows for both quick and around-the-clock delivery of insulin.

• It gives your child more freedom in what and when they eat than shots.

• It may lead to fewer extreme highs and lows than shots.

• It may improve your child’s A1C number.

There are also some risks of the pump. These include:

• It may not improve your child's blood sugar numbers.

• Blood sugar may need to be checked more often than with shots.
• Ketones may need to be checked more often than with shots. Your child’s healthcare provider will teach you how to check for ketones.

• The pump may be visible to others, which your child may not like.

• It may not be covered by health insurance.

• It may raise your child’s risk of weight gain and infections.

• It may raise your child's risk of diabetic ketoacidosis (DKA) if the pump or tube stops working. See "Understanding the risk of diabetic ketoacidosis (DKA)" below.

An insulin pump can be used with a child of any age, even a baby. To help decide if a pump is right for your child, think about these things:

• Counting carbs will be more important than with shots.

• Your child may still need frequent blood sugar checks.

• You’ll need to keep careful records of your child’s blood sugar readings.

• Single doses of insulin must still be given before meals.

• You must closely watch your child for high or low blood sugar symptoms.

• An older child must be interested in the pump and willing to wear it.

• You and your child need special training. Both you and your child must commit to learning how the pump works and how to use it safely.

• You must work closely with your child’s school to make sure your child’s diabetes care is supervised.

• You will need a back-up person trained to manage the pump in case of an emergency.

Diabetic ketoacidosis (DKA) is a serious condition that can happen if your child doesn’t get needed insulin. It can lead to a coma. Sometimes it can even lead to death. If the insulin pump stops working, DKA could happen soon after.

• Talk about the risks of DKA with your child’s healthcare provider.
• Learn what to do if the pump fails for any reason.
• Watch your child’s blood sugar closely. This is the only way to be sure that they are getting needed insulin.
• Always keep diabetes supplies close by.
• Be ready to give your child an insulin shot right away if needed.

For more information about diabetes, visit these websites:

• American Diabetes Association  at www.diabetes.org

• Children with Diabetes at www.childrenwithdiabetes.com

• Juvenile Diabetes Research Foundation  at www.jdrf.org

• American Association of Diabetes Educators  at www.aadenet.org

• American Association of Clinical Endocrinologists  at www.aace.com

• Endocrine Society at www.endocrine.org/topics/diabetes

• National Diabetes Information Clearinghouse  at www.diabetes.niddk.nih.gov

This sheet does not give all the information you need to care for your child with diabetes. Ask your child’s healthcare provider for more information.