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[IP] Yale program distributes pumps to kids

      (I found this article in the newspaper 12/27/00 and didn't know it was a
sidebar to the BASH article. It states *long-acting* insulin in the pump - but
it might not make sense to the layperson to use extremely short-acting
insulin. And, wouldn't you know it, the section with the BASH article was
missing from MY newspaper!!)
      Yale program distributes pumps to kids

      The Stamford (Conn.) Advocate

      Insulin pumps were first used more than 20 years ago, but they were big
and bulky. They've gotten more popular for two reasons: The pumps are slimmer,
and the insulin is longer acting.

      "Our biggest use of pumps has been over the last three to four years,
especially on very young children," says JoAnn Ahern, a diabetes clinical
nurse specialist who is the program coordinator at Yale. Yale has prescribed
the pump to about 250 patients over the last few years. The youngest was 18
months, and the oldest was 60 years, says Ahern.

      "The youngest kids do the best, those under 6, because their parents are
totally in control," she says. "Those age 6 to 12 do well, better than those
on shots. Teens are always a challenge, but if they're already on the pump,
they do better than kids on shots, but not as well as when they were younger
and their parents had more influence."

      While the pump is an effective insulin-delivery system, "it's not an
artificial pancreas," says Stephen G. Rosen, a Stamford, Conn.,
endocrinologist. "Patients still need to do a considerable amount of

      Rosen and Ahern says the family's support system is crucial.

      "Everyone needs to understand both the positive aspects of the pump, and
the problems," says Rosen, who says there are about 10 patients on the pump at
Stamford Hospital, all doing well. "You have to consider, 'how compliant is
the child,' you have to explain it to the parents again and again, and
consider the social situation. There are a lot of factors."

      Ahern says the parents must support each other.

      "They must both agree, and help each other. It's hard to do if you don't
have somebody supporting you," she says.

      On the other hand, "If your (child is) on shots, and nobody is
supporting you, it's the same thing."

      Ahern was the trial coordinator for a 1993 Yale study of teen-agers with
diabetes that revealed the benefits of the pump. "So we would give the pumps
to teen-agers and I just slowly moved down, down in ages. You do a teen and a
10-year-old says, 'What about me?' Then you do a 7, then a 6 and you finally
say, 'We'll try it.' When you see the results, it inspires you to offer it."
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