The use of insulin pump therapy in adolescents

Continuous subcutaneous insulin infusion (CSII) systems have been used in diabetes management since the mid-1970s. Investigators have reported encouraging results with CSII use in adult subjects with dramatically improved glucose control, reversal of some complications, and high acceptance and compliance rates. We have studied 10 adolescents and 3 young adults using CSII for diabetes management. Only the three young adults (ages 20, 24, 34 years) have had markedly improved metabolic control, sustained pump use, and made adequate psychological adjustment to CSII therapy. Adolescent subjects, (ages 9-17 years), experienced problems with peer acceptance of pumps, had difficulty with infusion needle insertion and skin care, were unable to perform home blood glucose monitoring consistently, made nonadvised manipulations of insulin dosage and reported mechanical problems with CSII devices more frequently than the young adult subjects. Mean duration of CSII use in adolescent subjects (6.1 months) was significantly less than mean use (30.6 months) among the young adults (p less than 0.01). Currently, adults appear to have greater success than adolescents in using CSII for diabetes management.