Diabetes: Children and the Insulin Pump

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Guest: Dr. Deborah A. Bowlby - Pediatric Endocrinology

Host: Dr. Linda Austin – Psychiatry

Announcer: Welcome to an MUSC Health Podcast.

Dr. Linda Austin: I am Dr. Linda Austin. I am talking with Dr. Deborah A. Bowlby all about diabetes. Dr. Bowlby, let’s talk about the insulin pump. What is an insulin pump?

Dr. Deborah A. Bowlby: An insulin pump is a small machine approximately of the size of a cellphone. It delivers insulin to a patient. A small little tube goes just underneath the skin and the pump allows the patient to determine how much insulin they receive. Using an insulin pump allows you to not do the insulin injections with a typical needle and syringe.

Dr. Linda Austin: So, how young can a child be a candidate for an insulin pump?

Dr. Deborah A. Bowlby: Age is not one of the criteria. We have our patients well controlled with diabetes, who know how to troubleshoot. As long as the family and a patient know how to treat lows, treat highs, and are responsible for their diabetes, any child can be considered for an insulin pump.

Dr. Linda Austin: Even a toddler?

Dr. Deborah A. Bowlby: Definitely, I have had toddlers; I have even had a two-week old baby on an insulin pump.

Dr. Linda Austin: That’s remarkable.

Dr. Deborah A. Bowlby: The easy part with a two-week old is the mother who could control everything. Toddlers are the challenge because they like to play with the buttons.

Dr. Linda Austin: It sounds like you never start with that, is that right, although with a two-week old, you can’t for a long before you go there up.

Dr. Deborah A. Bowlby: Correct. In general, our practice likes to have patients and parents get the basics of diabetes, so what I call the diabetes survival skills and then once the diagnosis has been dealt with the family, we can then transition them to a pump.

Dr. Linda Austin: I would imagine that would be very liberating in terms of not having all of those injections, can you achieve as good control of insulin levels with the pump as with injections?

Dr. Deborah A. Bowlby: An insulin pump definitely allows you to have good diabetes control. The decision to have insulin delivered by needle and syringe versus a pump is really a lifestyle choice and you are correct; many of the patients love being on the insulin pump because they do not have to take the injections.

Dr. Linda Austin: What’s the downside then of an insulin pump?

Dr. Deborah A. Bowlby: With an insulin pump, like any type of technology, you have to be responsible for it. You have to make sure that it’s working properly and what to do when it’s not working. One of the concerns with an insulin pump is if it stops working and you don’t recognize the fact that it’s not working, you can become ill quite quickly.

Dr. Linda Austin: How about swimming with an insulin pump?

Dr. Deborah A. Bowlby: Oh! It’s great. All our patients have to do is just disconnect from the actual pump and then they can go swimming and they leave the little catheter, the little tubing on as just under the skin.

Dr. Linda Austin: Well, that sounds like it’s a fantastic advance; say, actually had been around for how many years?

Dr. Deborah A. Bowlby: The first insulin pump came out in the 1970s and it was approximately the size of a knapsack and our recurrent insulin pumps are the size of a cellphone and patients really do enjoy them.

Dr. Linda Austin: Are they uncomfortable in anyway?

Dr. Deborah A. Bowlby: No, actually the insulin pumps are not uncomfortable. It’s a small plastic tubing that just goes right under the skin.

Dr. Linda Austin: Does insurance cover insulin pumps?

Dr. Deborah A. Bowlby: Yes, insurance companies cover insulin pumps.

Dr. Linda Austin: How about cleaning requirements?

Dr. Deborah A. Bowlby: As with anything that you are going to put under your skin, you want to make sure that the skin is clean before you insert the pump and you change the pump site approximately every two days.

Dr. Linda Austin: Dr. Bowlby, thank you so much.

Announcer: If you have any questions about the services or programs offered at the Medical University of South Carolina or if you would like to schedule an appointment with one of our physicians, please call MUSC Health Connection at (843) 792-1414.

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