Reports in Australia and New Zealand have shown that not only is
there an increase in the incidence of Type 1 diabetes in children,
but that it is occurring more in children younger than 5 years of
age.7
Gaining good glycemic control in young children with diabetes is difficult as there are some unique challenges to overcome:
| • |
unpredictable food intake |
| • |
unpredictable physical activity |
| • |
require very low doses of insulin |
| • |
have frequent viral illnesses |
| • |
the inability of the child to convey symptoms of hypoglycaemia to parents |
Insulin pumps are being considered more and more for toddlers and children as they have many features that can address many of these challenges and so assist in gaining better glycemic control.
New features of the Medtronic Paradigm insulin pumps have been designed to address many of these challenges;
| • |
ability to program a bolus dose for food which can be evenly delivered over a period of time and that can be cancelled if the child does not eat all of the food |
| • |
able to deliver repeated small bolus doses in accordance with their eating habits |
| • |
insulin is delivered in increments as low as 0.05u and each dose is precisely measured |
| • |
different basal patterns to cope with days of extra activity where not as much insulin is required or to cope with days of inactivity or sickness where more insulin is required |
| • |
the more physiologic delivery of insulin and the use of only short acting insulin helps to reduce the risk of hypoglycaemia |
| • |
the Bolus Wizard calculator helps to take the guesswork out of calculating the right bolus doses or correction dose and helps to keep the blood glucose levels within target |
Medtronic Infusion Sets and Inserters
| • |
Medtronic is the only company to have a range of infusion sets to suit all ages, even for babies just weeks old |
| • |
the soft Teflon cannula of the Medtronic Silhouette and Quick-set infusion set allows the child to play and do normal child activities |
| • |
Medtronic have automatic inserters to quickly and painlessly insert the cannula |
Safety of insulin pumps with young children
One of the major concerns has been the safety of insulin pump therapy in toddlers and children.
Safety of the Paradigm insulin pumps;
| • |
there is a child block that disables the buttons so that no insulin can be accidentally programmed |
| • |
a remote control so that the child does not learn the controls of the pump |
| • |
the pump is small so that it can be easily worn in a very small backpack or in a colourful small soft pouch on a belt or in a pocket. Children learn very quickly not to interfere with the pump. |
| • |
the Paradigm pump does 1 million safety checks a day |
There are many studies that have looked at the safety and efficacy of pump therapy in teenagers and adolescents, however, the use of pumps in toddlers and young children is relatively new. Recent studies however, from the US and Australia have shown that it is both safe and efficacious with 53% less hypoglycaemic episodes and improved glycemic control with lower HbA1c.1-6
Frequency of parental contacts with health personnel in one study of children on insulin pumps, declined by 80%, reflecting increasing parental confidence and independence in diabetes care.
Researchers have concluded that the remarkable effectiveness of continuous insulin infusion in their youngest patients indicates that the child’s age should not be a barrier to the use of insulin pump therapy.
The answer to the specific needs of toddlers and young children:
Medtronic Paradigm® REAL-Time System
|
