Teens at Risk for Injury and Death When Using Insulin Pumps
In 2005, the Food and Drug Administration (FDA) was notified of 5 teen deaths that occurred with the use of insulin pumps. This raised a red flag for the FDA, and in an effort to reduce the potential risk to teens who use an insulin pump and find out why fatalities occurred, a comprehensive ten year retrospective study was conducted.
The study appears in this month's issue of Pediatrics - The official journal of the American Academy of Pediatrics.
1,594 adverse event reports were reviewed for insulin pumps used by teens. Thirteen deaths occurred during those ten years (2 of which were suspected suicide attempts), and many additional reports of injury, including severe hypoglycemic or hyperglycemic episodes were noted and appeared to be related to the use of the pumps. Eighty-two percent of the adverse events resulted in teens being hospitalized. There were 102 events in all. This is 6.4% of the teen population who use the pumps.
Several causes for adverse events were identified during this study, including:
- Compliance issues
- Need for more education
- Sports and other related activities
- User damage to the pump, for example, dropping the pump or otherwise damaging it with use.
The majority of teens who use insulin pumps do not suffer from adverse events. The pumps help many teens maintain better compliance with their diabetes, by making it easier to enjoy social events and feel more like they can have a normal life like their friends.
But, teens may require close medical and parental supervision, to make sure that they understand how the pump works and that they are using it correctly and making sure that it does not malfunction or become damaged.
Read the abstract as it appears in this month's issue of Pediatrics...
Photo courtesy of Stockbyte/Getty Images
Comments
Having a child with Type 1 for 8 years (I have a 10 year old diagnosed at 2)and who has been pumping for 7 years, I have seen it all when it comes down to care from a parental standpoint.
It is draining and exhausting and frustrating at times, but my wife and I remind ourselves we are really doing the easy part, our child has to live this this forever.
Many of these kids in the study likely had little parental help or intervention. Many parents I hear from think after the child reaches a point in adolescents they are capable of dealing with it themselves. Many take a hands off approach as they have been dealing with it for years, so now it is up to the child to take over. Bad idea, bad outcome.
Our child at age 10, knows more about the pump than our educator. Has never damaged it, and takes care to protect it. Knows when we need to make basal rate changes, etc. If fact the child get upset when we do take care of things.
A poorly designed study that likely did not take any parenting into account and then paints a skewed picture for everyone else.
facts are facts but without context as Bill calls out this is hardly useful information. It also fails to point out how this compares to adverse events for all similarly aged children with insulin dependent diabetes. Unfortunately, there are many times more children who do not use an insulin pump (an advanced tool with built-in safety features) but rather use an insulin pen (mid-grade tool without safety features) or a manually drawn syringe of insulin (basic tool without safety features). The FDA study should have been shared with some relationship to the imperfect status of tools and the complexity of children having to sustain themselves with the two-edged sword called insulin (with or without support).
How many and what percent of children with diabetes not on pumps had similar adverse events we will never know. Most likely because the non-pump regimen doesn’t lend itself to the patient’s need to report these adverse events to the FDA.
Comment: What a poorly written article. You can read statistics in many ways. As the parent of a teenager who has been using a pump for years I can tell you that it has made a WORLD of difference in his health and his quality of life. I love the line”..teens were careless and took risks.” Just diabetic teens on pumps exhibit this behavior? Now that’s a story!
The vast majority of teens who use pumps use them correctly and have a great sense of maturity and responsibility. Many kids with type 1 have been dealing with it for so long that they know they need to be more responsible than the average teen. The FDA did the study because 5 teen deaths occurred in one year, 2005. If 5 teens die in one year, then something needs to be looked at, adressed, and written, because even one death is too many.
More wasted money by a government organization. I have had Type 1 for over 28 years now and I have just gone on the pump. I could fill up pages of my past with problems I had with injecting the “old school” insulins to control this disease. The pump is not perfect, but it sure is a lot better than the prehistoric treatment I used to use. We need this change in treatment because it is better and it will take more time to reach STAR TREK with the FDA at the helm. I would rather here an article on why Insurance companies get to dictate how Diabetics control themselves and get away with it…
Minimed representative in Tulsa failed miserably. When I was in N. Carolina the Minimed representatives were very helpful.
I have been trying to get glucose monitoring on my pump and representative completely ignores me.
My son was just diagnosed with Type 1 on 3/24/08. We have our first appointment with the pump educator next week. This article doesn’t do anything but give the pump a bad name and I think that is a shame.
Everyone I have spoken with, including our doctor, is an advocate of the pump. My son is extremely excited to be able to get a pump. Our doctor said this, “The difference between insulin pens and insulin pumps is similar to the difference between having a bike and having car - you can go farther with the car using a lot less effort, but a car can also kill you faster than a bike. It’s all in how you drive it.”
And I totally agree with him. This article does not scare me away from the pump. If anything I am just happy that my son doesn’t have to inject himself so many times a day (and he is too!)
The pump does not to be used with caution and the parents need to be involved. Perhaps more needs to be done by pump educators during the screening process to make sure these kids can handle it - especially if their parents don’t care enough to stay involved with their treatment.
This study and the reporting was a shame.Pumps aren’t the problem here.
It would have been better to say “Teens at Risk for Injury and Death When Using Insulin”. Because that’s the truth. Whether administered by injection or insulin pump this is a dangerous hormone. Parental supervision and training for teens is a must.