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[IP] Insulin pump used to treat diabetic baby - article

Arkansas Democrat-Gazette
Insulin pump used to treat diabetic baby 

Date: 8/3/2000 
Category: NWAnews 
Page: A1 
A baby at Arkansas Children's Hospital is believed to be the
youngest wearer ever of an insulin pump for diabetes.
Maverick Colt Roe was born healthy, but a bit smaller than
expected, on July 22. Twelve hours later his temperature dropped,
he began to breathe rapidly and his blood glucose level
skyrocketed to more than 1,000 milligrams per deciliter -- about
10 times above the upper limit of normal.
Doctors first thought he had an infection in his bloodstream. But
when his blood glucose level continued to soar, they diagnosed
neonatal diabetes. 
The condition, which is temporary about half the time, is rare.
And insulin pumps in small children, let alone infants, are
practically unheard of. Experts said Wednesday that they had
never seen or read of the device being used in a child so young.
If Maverick continues to thrive on the pump, his case may mark a
sea change in the treatment of diabetes in children and babies.
Though insulin pumps have existed for two decades, they only
began to be widely used about five years ago and are still hardly
prescribed in children because they require so much attention. 
The insulin dose delivered by the beeper-size device must be
adjusted according to a calculation, and the needle and catheter
through which the pump is attached to the skin must be changed
"It's very rare to have babies born with diabetes. It's like one
in the millions," said Dr. Richard Furlanetto, scientific
director for the Juvenile Diabetes Foundation in Buffalo, N.Y.
Though Maverick's form of diabetes differs slightly from
juvenile-onset or insulin-dependent diabetes, he is being treated
the same way. The latter disease strikes about one in 250 people
nationwide and results when something -- typically a toxin or
virus -- prompts the body's immune ystem to assault the pancreas. 
Certain cells of the pancreas become damaged and stop producing
enough insulin. Without insulin the body cannot get nutrients
such as glucose into the body's cells.
Researchers believe there is a genetic link. Yet often, as in
Maverick's case, the patient has no family history of the
Though the prognosis is good with early diagnosis and careful
adherence to treatment, people with diabetes are predisposed to
complications such as visual problems and kidney and nerve
In neonatal diabetes, Maverick's type, the pancreas produces
insulin but doesn't release it normally, perhaps because the
pancreas is not fully developed.
About one in four babies with the syndrome begins to release
insulin normally after a short time. But one quarter become
diabetic again when they are older. Roughly half of the cases
remain diabetic permanently.
There is no cure for juvenile-onset diabetes, though it can be
controlled with daily insulin injections and frequent blood
glucose tests. Many people prefer the pump because it eliminates
the need for shots.
The device may actually be advantageous for children because
instead of estimating how much they will eat over the course of
the day and calculating an insulin dose on that basis, their
parents can give them more insulin after a big meal simply by
pressing a button, said Dr. Stephen Kemp, the pediatric
endocrinologist who is treating Maverick.
Before Maverick began using the pump, he received five or six
shots a day and his blood glucose level was still too high. Now
the needle and catheter are changed every few days, and one of
his parents pricks his heel to test his blood glucose every few
To prevent Maverick or his 21-month-old brother, Wyatt, from
playing with the buttons, the pump's keypad is locked and his
parents control it with a special key chain.
"There's a mindset that the pump shouldn't be used in children
until they're old enough to do the calculations you need, which
is true if the children are the ones in control of the pump,"
Kemp said. "But if the parents are in control, it doesn't matter.
We've had very good success with these 2-year-olds [on the
Wednesday, the doctors at the Little Rock hospital began having
success with scrawny Maverick as well. His blood glucose level
remained about 128 all day. His mother, Bridget, who has been
sleeping in the hospital's waiting room since shortly after he
was born, hoped she would get to take him home to Arkadelphia on
But a risk, beyond the pump malfunctioning, is that Maverick
could get too much insulin. Blood glucose levels change quickly,
rising and falling in response to food intake, exercise and
Because Maverick is breast-feeding and it is impossible to know
exactly how many calories he eats per day, the doctors must
approximate and calculate his dose based on the length of his
They overestimated Tuesday night -- something that occurs almost
daily for most diabetics -- and Maverick's blood glucose level
slipped to 22. Older diabetics may become clammy, sleepy,
irritable or confused when they are hypoglycemic, but Maverick
showed no signs and nurses caught the problem with a routine
blood check.
If he begins to produce insulin on his own, doctors will taper
his dose and eventually remove the pump. He has gained several
ounces -- a good sign -- and his parents are optimistic.
Bridget Roe quipped that she and her husband, Bryan, will
research a name more carefully before choosing it for their next
child: Maverick was named after a 3-year-old at a day-care
center, and the Roes learned later that that little boy is
diabetic, too.
The blue pump, not much smaller than Maverick's head, looks so
much like a beeper that "I just say he's very popular," Bridget
Roe said.
That joke may be an indication of his future.
Graph: Arkansas Democrat-Gazette
SOURCE: Pumsit.com
How an insulin pump works
Slug Line: xbabyth 1ANW (NEW HEAD ONLY) copy
Take care, Kerri, alulitsuti (mother of many children) & the
little guy due 3/10/01 
"There is a special magic and holiness about the girl and woman.
They are the bringers of life to the people, and the teachers of
the little children." - Sweet Medicine, Cheyenne
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