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[IP] Rare newborns spur pioneering use of insulin pumps

Rare newborns spur pioneering use of insulin pumps
By Lucy Beaumont
August 15, 2003

 Mason, who is being treated with an insulin pump for diabetes, with his mother,
Kylie Johnston.
 Neonatal diabetes occurs just once in every 400,000 births, yet the Royal
Children's Hospital is treating two sufferers, including four-month-old Mason.

 "The last one I can remember was about eight years ago," said the hospital's
head of endocrinology and diabetes George Werther. "We got two within a week. It
was bizarre."

 This incredible coincidence - the babies are unrelated, with Mason born in
Darwin and the second baby in Melbourne - has allowed doctors to pioneer the use
of insulin pump technology in newborns.

 Both infants were born prematurely. Mason, six weeks' premature, needed to gain
weight and have several heart operations before going on the insulin pump last

 "It was picked up because, paradoxically, small babies are at risk of low blood
sugar," Professor Werther said. Surprisingly, Mason's blood sugar was high, he

 Children who develop type 1 diabetes have a predisposition to it, but neonatal
diabetes means newborns need insulin - usually produced by the pancreas to
transfer glucose from blood to cells - within the first month of life.

 Without treatment, the babies "wouldn't have survived long at all", Professor
Werther said.

 Studies suggest that a genetic mutation causes the condition but Peter
McDougall, the hospital's director of neonatology, said Mason's small size of
just over a kilogram might have contributed.

 "Whatever made him small also made his pancreas not work very well," Dr
McDougall said.

 Fortunately, neonatal diabetes is usually resolved in the first six to 18
months of life. In the meantime, blood sugar levels are difficult to manage.

 After doctors experimented with injections of insulin and intravenous drips,
diabetes educator Rebecca Gebert suggested trying an insulin pump.

 The pager-like device, with an in-built syringe and line feed under the skin,
is programmed to deliver insulin as needed. "Nobody anywhere would be using them
in these very tiny babies," Professor Werther said.

 The pumps, loaned to the two babies by the manufacturer, cost about $8000 each,
with consumables adding $300 for each baby in monthly expenses.

 Mason's mother, Kylie Johnston, expects to take her baby home to Darwin in a
fortnight. "I reckon he's pretty tough for a little fella," she said.
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