Type 1 Diabetes New Pumps & Monitors for Diabetics with Type 1

Managing type 1 is a tall order for many kids. "The whole system hinges on adherence at every step: testing blood sugar, giving shots, recording every little thing they eat," explains Naomi Neufeld, M.D., clinical professor of pediatrics at the University of California, Los Angeles. "But it doesn’t always happen, especially when your kids aren’t in your sight."

The good news is that several innovations are making it easier for kids—and their parents or guardians—to keep careful control.

Monitors

Wireless blood-glucose meters using cell-phone or Bluetooth® technology store readings and can transmit them to a computer at home or at the doctor’s. The physician can view your child’s blood sugar history on a single screen, which makes it easier to spot trends and problems.

Talk to your doctor about the right device for your child. Some wireless monitors are not FDA-approved for kids, and your insurance may not cover them all. Some doctors also use the continuous glucose monitor with kids, even though it’s not FDA-approved for use with children. This device, which measures glucose levels in the tissue fluid under the skin, isn’t a substitute for the blood glucose monitor.

Insulin pumps

These wearable pumps for continuous administration of insulin can be a boon to kids. In one study from the Joslin Diabetes Center in Boston, school-age children on pumps monitored themselves more frequently, needed less insulin daily and had better blood sugar control than those using standard injection therapy. Studies have found that children as young as 18 months can use the portable pumps effectively. The pumps provide a baseline level of insulin throughout the day and can be programmed to give rapid-acting insulin analogues before or immediately after meals. Someone still has to enter the amount of insulin to administer, and that depends on what the child is eating.

Combination monitor-pumps

"These devices are the most promising to pediatric endocrinologists," says Dr. Neufeld. The pumps sense glucose and automatically adjust insulin. The first model may be available this year.

New ways to deliver insulin

For toddlers, rapid-acting insulins are ideal. "At this age, you can’t always predict what they’re going to eat," says Dr. Neufeld. (Inhaled insulin, which acts rapidly but lasts as long as regular insulin, is pending approval for use in children; its effect on developing lung tissue still needs to be determined.)

Endocrinologists are also investigating the treatment of other diseases in the hopes of finding applicable technologies. A new pen for injecting growth hormones, for example, records time and dose with an iPod-like device, says Dr. Neufeld, "and there’s no reason it couldn’t be used for diabetes."

Be receptive to changes in technology, say experts, and ask your doctor to keep you up-to-date. The latest—and future—devices won’t take patient responsibility out of the equation, but they will make your life and your child’s life easier.

Source: Diabetes Care, November 2006.

Ask the Right Questions

Thinking of trying a new device? The American Diabetes Association advises asking your doctor:

• What experiences have other patients had with it?
• Have insurance companies covered the costs?
• Are there benefits to a pump over injections?
• What’s involved in going from injections to a pump?
• Is it clear how much insulin to use with a pump?
• If my child gets continuous insulin, how will it affect what she eats and how she exercises?
• What kind of training will my child and I receive?
• How often will blood sugars need to be checked?
• Does it hurt?

The latest crop of diabetic devices offer exciting possibilities for glucose control for children with type 1 diabetes—and adults, too. Find out which one is right your family.

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Molly Lyons is a writer for MediZine, LLC. Robert A. Barnett is Content Director of HealthyUpdates.com, a health education website produced by MediZine, LLC.