The youngest pump user ( Sept 9, 1999 )
(translated by Dr. Wolfgang Baer, director Insulin Pumpers)
The orginal article was published in the German Diabetes Journal,
Sept, 99, by GŁnter Nuber
Laura was born in early July in Berlin; Five weeks later she was diagnosed with Diabetes. Since August she has become the youngest insulin pump user in the world. In an interview with Diabetes-Journal Dr. Thomas Danne says: ' When Laura was five weeks old she got a fever of 40 C (104 F). Her doctor sent her to the hospital where among other symtoms a blood sugar level of 1000mg/dl was measured. She imediately received intravenous Insulin. After four days someone from the clinic called and because she could not tolerate the glucose level fluctuations. Thereafter Laura was transfered to the Berliner Charite in the department where Dr. Danne is the head physician. What was done? In the Berliner Charite Laura was put on the pump imediately. "This worked perfectly." Said Danne. With a Minimed-Pump using Insulin Lispro (Humalog); Laura got a base rate of (2.5 u insulin per 24 hours) and after eating an extra dose depending on the (meal sic..) If one were to use subcutaneous insulin one would have to administer shots 6 times daily during meals on top of the base rate" says the chief physician. The pump is attached to her diaper, and the tube is long enough so that she can sit in the bath while the pump stays outside. In the world literature there are less than 100 reported cases of diabetes immediately after birth. Laura is probably the youngest pump user. We know of no one younger. In the last few years Charite treated four post birth Diabetic cases. But with all of them insulin injection treatments were difficult. I remember telling myself "next time we will try the pump". In parallel Danne and his team decided to try the pump as well. "The primary goal with such a small patient is to avoid low sugar levels - one aims for a slightly elevated level. Since Laura uses the pump her sugar level never dropped below normal, the lowest levels were 56. Sometimes it has gone to 300 but never over 400 mg/dl. With children with prenatal diabetes who do not use the pump, extremes of over 500 are common. The normal dosage cycles are too long for this (since, sic) Laura does not have sufficient body fat. We therefore have a special setup" explains Danne. "Every three days the rate is adjusted by a nurse who visits the home. Also the insulin mixture is specially prepared for Laura, since U-40 Insulin is too concentrated for the little girl. By the way 30 years ago twin sisters in the Berlin Charite were dignosed with Diabetes which disappeared a year after birth and later returned This case was so unusual that we still remembered them. Laura is the daughter of one of the twins."