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How can my son stop feeling insecure about his insulin pump?

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The question: My son has an insulin pump to help control his diabetes. But now that he's started high school, he's become very self-conscious about it. Some of the kids have made fun of him. Any advice for helping a diabetic kid be okay with himself and his condition?

The answer: For readers who have never seen an insulin pump, this is a medical device about the size of a deck of cards that is worn on the belt or carried in a pocket. These high-tech gadgets are filled with insulin and then programmed to continually deliver a steady supply of this life-saving hormone. (Canadians remember that insulin was discovered at the University of Toronto in 1921 by Drs. Frederick Banting, Charles Best, and John MacLeod, revolutionizing the treatment of diabetes and earning the researchers a Nobel Prize in the process.)

The insulin pump is connected to the patient via a small tube whose tip is implanted, by the patient, under the skin of the abdomen. Although the tube must be replaced and relocated by the patient to a new site every three days, the pump eliminates the need for injections of insulin. In the era before insulin pumps, people with diabetes would inject themselves with insulin four or more times a day.

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While pumps are relatively small and can usually be worn discreetly, it can be more difficult to hide the finger pokes for blood sugar testing (conducted multiple times a day) and the insulin pump programming that patients must perform before every meal and snack. Insulin pumps can be made more appealing to younger children by decorating them with stickers (think hot pink or Spiderman) or by carrying the pump in a designer pouch. This of course is no help to your teenage son. Instead, he may wish to consider the following strategies:

1. Sign up for a favourite activity such as a sport, school club, or other social hobby. Participation builds social connections, increases self-esteem, and reassures peers that young adults with diabetes are just like anybody else. In my pediatric diabetes clinic we follow boys and girls with diabetes who play varsity and intramural sports (including rugby and swimming) and one young woman who is president of her high school student council.

2. Make a presentation to his class about life with diabetes. Although not all teens will be up for this, educating peers about diabetes will reduce other student's fear and ignorance, two factors that are often associated with teasing and bullying. It's also hard for peers not to be impressed with the diabetic daily routine of multiple finger pokes and injections.

3. Connect with other adolescents with diabetes. It can be comforting to know that you are not alone in facing the challenges of living with this disorder. Your local diabetes clinic should be able to connect you with other families. The Canadian Diabetes Association sponsors summer camps for children and teens with diabetes. These camps are a very popular way to meet others with diabetes and have a great time.

Finally, it is not uncommon for teens with a chronic disease such as diabetes to go through periods where they struggle to cope with the daily, never-ending demands of their illness. Refusing to accept the diagnosis and wondering "why me?" is commonplace. Support from mental health professionals can be extremely helpful in these situations. If you have concerns, don't hesitate to discuss this further with your physician or diabetes care team.

Dr. Michael Dickinson is the head of pediatrics and chief of staff at the Miramichi Regional Hospital in New Brunswick. He's a staunch advocate for children's health in Atlantic Canada through his involvement with the Canadian Paediatric Society.

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