The use of an insulin pump significantly improves blood sugar control for kids and teenagers with Type 1 diabetes, but experts are surprised to see that the device is underused in several places.

Insulin pumps are attached to the skin and can deliver levels of insulin through a catheter, mimicking the body's normal release of insulin.

Researchers found that insulin pumps are less common and are only used by less than half of children and adolescents in England and Wales who have Type 1 diabetes than among young patients in the United States, Germany or Austria.

In a study published in the journal Diabetologia, researchers examined data collected from three registries in three regions during 2011 and 2012 that included 54,410 kids and teenagers with Type 1 diabetes. They found that the results of their study were different from the consensus statements released by a joint insulin pump management task force.

The study said that the use of insulin pumps was higher in girls than in boys, and was lower among ethnic minorities than whites, where 22 percent of minorities use an insulin pump while 34 percent of non-minorities use the device.

In Wales and England, only 14 percent of patients in the registry use an insulin pump. Researchers noted that glycemic control in these regions is lower than in the United States and in Austria and Germany. In the United States, 47 percent of kids use an insulin pump, while in Germany and Austria, the rate was 41 percent.

Younger kids were also less likely to use insulin pumps than older kids, but data suggests that these devices can be effective for the former.

"It really is a call to arms that we all need to be doing better ... We need to think more broadly about who is a pump candidate and make sure we're providing equal access regardless of age, ethnic status, or gender," said Dr. Jennifer Sherr, lead author of the study and an assistant professor at the Children's Diabetes Program at the Yale School of Medicine.

Scherr also mentioned that there is a notion about people or children being attached to something, so she wonders how day care providers, school nurses or teachers could handle the technology that these kids use. Patients realize using insulin pumps are easier than injecting them, she said.

In the UK, insulin pumps are less common because the National Institute for Health and Care Excellence released restrictions on their use on children. Scherr said that experts are looking for mechanical solutions in the form of an artificial pancreas, but half of children with Type 1 diabetes do not even have the opportunity to use an insulin pump, which they should already be using by now.

"We need to get that to our kids," added Scherr.

Photo: Alan Levine | Flickr

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