WASHINGTON – The gadget 10-year-old John A. McBride has been begging his mom for is not the latest hand-held video game.
In fact,it could easily be mistaken for a pager,but it's a medical device that is changing the way people think about treating diabetes.
The blond fourth-grader,who goes by Jack,will become one of thousands of children in the United States who control their diabetes by wearing insulin pumps.
“There's one the size of a business card,” Jack said,using his fingers to describe the dimensions of the insulin pump that will become his surrogate pancreas next month.
Jack,who lives in the suburb of Gaithersburg,Md.,was diagnosed with the disease at age 3. Out of the two types of diabetes,his is the most chronic,commonly referred to as juvenile diabetes,and requires daily insulin injections from a nurse when he's at school.
Insulin pumps are small monitors about the size of a cell phone and can be worn in a pocket or on a belt and deliver insulin in a steady,continuous dosage through a catheter inserted under the skin.
Instead of injecting himself with insulin several times a day,Jack will prick himself up to eight times a day,drawing small blood samples that are placed on testing strips. The strips are put in to a hand-held device that transmits radio signals to the pump,which uses the information to determine how much insulin to release.
He has read about them extensively,he said,referring to a Sports Illustrated article about Detroit Tigers pitcher Jason Johnson,who uses an insulin pump.
“He had to get it OK'd so it wouldn't distract the batters,” said Jack,who wears a red nylon bracelet with a silver-plate inscription identifying him as a diabetic.
He will be able to remove the pump for brief periods when he plays basketball,soccer and baseball. The devices come in every shade. Jack decided on black,a color he thinks will be less noticeable.
“I don't want people staring at it all day,” said Jack,who until recently was the only diabetic attending his private Catholic school in Darnestown,Md.
Pumps have been around for 10 years but now that they are smaller and easier to use,they are among the best technology to help children with diabetes lead normal lives,said Dr. Gail Nunlee-Bland,an associate professor of pediatrics and chief of endocrinology at Howard University Hospital here.
“Most kids who eventually go on the pump think that it improves their lives significantly,” Nunlee-Bland said.
For Jack,the pump will mean independence,said his mother,Michelle McBride,a registered nurse who has monitored her son's blood sugar levels and carbohydrate intake since he was a toddler.
“I guess I've always kind of been in control,” McBride,43,said. “I think what makes me nervous about this is the fact that I'm a little lacking in technology smarts. But I'm confident that he's probably going to be teaching me.”
McBride said she has been hesitant since her son began asking for a pump age 5 and only recently agreed to allow him to get one.
“I told him he had to wait until he was 10,” McBride said,adding that the last five years have gone quickly.
Although some of McBride's relatives have another type of diabetes,neither she nor her husband,Tim,43,or their daughter,Regan,6,have the disease.
Nunlee-Bland estimated one in four children with juvenile,or Type 1,diabetes use pumps,which have become a widely accepted alternative to traditional needle injections.
There are drawbacks to insulin pump treatments,said Nunlee-Bland. Catheter sites can get infected if catheters are not changed every three days. Teenagers also tend to rely heavily on the pump,forgetting to monitor their blood sugar throughout the day.
“Even though it does give you flexibility,and people like it,it's a lot of work,” Nunlee-Bland said.
But more insurance companies are willing to foot the bill for the pumps,which cost from $5,000 to $7,000,Nunlee-Bland said,because the treatment is more cost effective in the long run.
The Juvenile Diabetes Research Foundation estimates that $2.5 billion will be spent worldwide on Type 1 diabetes research in the next year. That includes studies on a possible cure involving transplanting stem cells that secrete insulin.
Jack said he doesn't plan to wear the insulin pump for the rest of his life.
“Just until they find a cure for diabetes,” he said.