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Tuesday, May 6, 2008

What's risky for teens is parents: Insulin pumps for controlling diabetes

Many newspapers described the FDA study by Dr. Judith Cope and others in this month's issue of the medical journal Pediatrics on the risks to teenagers of insulin pumps for their diabetes. Here’s the reaction of Reagan Schweers' mom, from her blog:

"Insulin Pumps Risky for Teens" was the title of an article I read in the Dallas News this morning. Right next to the article was a picture of my son's insulin pump.

I read the article with a fairly open mind. I know that the idea of a headline is to grab attention. Ok, so I was grabbed. The article wasn't especially informative so I got online to check out the "study" that was mentioned. The study was from a well-known medical journal, Pediatrics. Since I worked in pharmaceutical sales and have read MANY medical articles, I'm not afraid to wade through the data to figure out what the study really said.

 So here's my take on things.

What the FDA found over the course of 10 years of data was that teens do risky things and aren't the best at caring for their $6000 medical device. Many of the incidents that had occurred were due to teens doing stupid things - dropping their pump, ignoring error messages, ignoring alarms, not checking their infusion lines. Of course, my question in all this is, since when is it the sole responsibility of the TEEN to do what the PARENT should be doing? Folks, diabetes is a serious long-term disease. Why would you not review your teen's blood sugar numbers? Why would you not make sure they are using their pump properly? This is a matter of life and death and you are FOOLISH as a parent to ASSUME that your teen is doing everything perfectly.

 I must admit that my son takes care of his pump and his diabetes 100% himself. He is FASTIDIOUS about keeping his blood sugar in control. But my husband and I always check behind him. His endocrinologist checks behind him. The diabetes educator in the endocrinology office checks behind him. And his HbA1C doesn't lie. If it's off, then we know he's not controlling his blood sugar or something is amiss with the pump.

In order to get a pump in the first place, the endocrinology office made Reagan test drive a pump for 4 days to see if he'd like it or not. You also have to go through their training program to even be considered for a pump. Then the pump manufacturer representative came to our house to train us extensively for using the pump. Reagan and I both reviewed the materials that came with his pump.

What we have had with his pump is MUCH better diabetic control of his blood sugar. This means (and is scientifically proven) that he will have less chance of losing his eyesight, losing a kidney or even a foot later in life. He has more freedom to live a "normal life" than he did giving himself multiple injections per day. We are able to closely titrate his insulin dose round the clock with the pump - much closer than we could with multiple injections of insulin.

AND...we just got the new continuous glucose monitoring system and he will be trained on that on Wednesday. He will be able to tell 24/7 - anywhere - anytime - what his blood sugar is. I can't tell you how important that is given the fact that he is will soon be driving solo. Or how important it will be when he's participating in a marching band competition and can't carry his blood sugar test kit with him everywhere. And, NO, insurance wouldn't even pay for it...(but that's a blog for another day).

I guess what makes me most frustrated is that this now gives insurance companies more ammo to say "no" to a device that has given many teens and their parents enormous freedom and peace of mind. In fact, the majority of teens who use an insulin pump will live longer and healthier lives - check that 10-year study. Honestly, what's risky for teens is parents who aren't involved in their lives. It's a partnership with your teen and the endocrinology staff. The pump is the best thing that's happened to Reagan as a diabetic.

Advice: Managing your child's diabetes calls for a partnership of you, your child, and the endocrinology staff.

Read another story about partnership in diabetes care.

Thanks to Reagan Schweers' mom for the source story in her blog, "A little of this and that."

1 comment:

Schweers' Mom said...

Hey Ken - thanks for your note that I got in the mail today! I appreciate you posting my post on your blog. We are very satisfied with Reagan's pump and I know that he would NOT go back to shots (Lantus and Humalog). I would encourage any parent of a type 1 diabetic to explore an insulin pump for their teen. It has been a very positive experience for us.

Thanks again!
Lori Schweers