An insulin pump that provide continuous release of insulin provides good control of blood sugar (glucose) in very young patients with type 1 diabetes, according to a new report in the journal Pediatrics. Researchers think this treatment may be superior to multiple daily injections in lowering the risk of episodes of severe low blood glucose, or hypoglycemia.

“Pump therapy has been shown to be a safe and effective alternative to multiple daily injections in adults and older pediatric patients.” Dr. Stuart A. Weinzimer and colleagues from Yale University, note. Its use in very young children, however, has been limited.

To investigate further, the researchers examined the safety and effectiveness of the use of an insulin pump in 65 children, between the ages of one and seven years old, with type 1 diabetes. The team compared measures of blood glucose and treatment complications in the year before and during pump therapy.

An average decrease blood glucose from 7.4 percent to 7.0 percent was seen after 12 months of pump therapy. Improvements continued even after four years on the pump. Severe hypoglycemia rates also decreased in the group as a whole by 53 percent.

No episodes of diabetic ketoacidosis, a potentially fatal complication that leads to a buildup of glucose in the blood, drowsiness, vomiting and other symptoms, were observed in the year before pump therapy. However, in the postpump period, there were four episodes.

The researchers note that this study is the first to show that the insulin pump is successful in children who have caregivers, such as nannies. Children who received daytime care from paid caregivers experienced significant reductions in blood glucose.

SOURCE: Pediatrics, December 2004.