A new service aimed at helping children with type 1 diabetes to better manage the condition has begun in Cork.

The service centres on the use of insulin pumps, which are small computerised devices that replace the need for continuous insulin injections. The device continually releases insulin under the skin, helping to keep blood glucose levels under control.

Children with type 1 diabetes normally receive insulin injections up to five times a day. This new service is being made available to suitable children in the Cork and Kerry area. Priority is being given to children under the age of five.

According to the HSE, which is running the service as part of its National Diabetes Clinical Programme, ‘this is the first dedicated ‘pump school' for children with type 1 diabetes in Ireland and the first time insulin pump therapy can be offered outside Dublin'.

Children, along with their parents, teachers and any other relevant carers, will be trained in how to use the device at a dedicated pump school by a consultant-led team from Cork University Hospital (CUH). The school takes a day-and-a-half to complete.

An insulin pump is the size of small mobile phone. It is attached to the child via plastic tubing. At the end of the tubing is a needle which is inserted under the skin. This allows the pump to deliver a continuous amount of insulin 24 hours a day. The amount of insulin delivered can be changed by the child (or their parent) based on their requirements.

As part of the pump school, the child wears a pump containing salt water for seven days. This allows them to spot any problems they may have. Usually by the third week, the child is well able to use the pump properly. Intensive support is offered throughout this time by the diabetes team.

According to Dr Stephen O'Riordan, consultant paediatric endocrinologist at CUH and national clinical lead for the insulin pump programme in the under fives, insulin pumps are now considered the gold standard for children with type 1 diabetes.

"Pump therapy improves blood glucose control and quality of life and reduces the long-term complications associated with diabetes such as blindness, heart disease and kidney failure. There is a significant practical benefit of pumps over injections for children and their families, for example, a reduction from five insulin injections per day to one infusion set change every two to three days," he explained.

However, he emphasised pump therapy is ‘not for all and careful patient selection is at the core of successful insulin pump service'.

This new service is provided by the CUH team in Blackrock Hall Primary Care Centre in Mahon. Currently, there are over 400 children with type 1 diabetes attending CUH.

To date, 20 children have begun pump therapy in Cork and it is envisaged that a further 20 will begin therapy this year.

"In the past, children from this area had to travel to Dublin hospitals to access insulin pump therapy. The service is at an early stage of development, but it is a significant advance for our services in Cork," commented Gabrielle O'Keeffe of the HSE Community Services in Cork.