Managing type 1 diabetes in pediatric populations is more than controlling blood glucose levels.
“Management of children and adolescents with type 1 diabetes is complex, time consuming, requires a team and there is an enormous ‘agenda’ to think about beyond blood glucose control,” said Joseph Wolfsdorf, MB, BCh, who will be addressing these challenges in two Meet-the-Expert sessions on Saturday.
Dr. Wolfsdorf, who is Director, Diabetes Program and Professor of Pediatrics at Boston Children’s Hospital, will provide a brief overview of national statistics on prevalence and incidence of diabetes in the pediatric age range and racial/ethnic differences and share how to make an accurate diagnosis.
“We’ll discuss the developmental context in which management of diabetes occurs and differing roles of family at each developmental stage,” he said.
He’ll also provide a summary of the American Diabetes Association standards of care in diabetes as they pertain to children and adolescents and emphasize the importance of a multidisciplinary team care. Encompassing the physician, diabetes educator, dietitian, and mental health professional, among others, the multidisciplinary team has a specific role for each member, he noted.
“National data show that only a minority of patients are achieving ADA targets,” he said, so he’ll cover how to initiate insulin therapy, particularly basal-bolus (multiple daily injections and pump) therapy.
Additionally, he will cover insulin resistance and developmental issues and challenges of adolescence, screening guidelines for autoimmune comorbidities,
managing cardiovascular risk factors such as hypertension, dyslipidemia and smoking) and screening for microvascular complications.
These challenges make the health care transition for the late adolescent and “emerging” adult critical for the endocrinologist.
“Preparation is important,” he said. “Transition to adult care must be planned. Glycemic control may deteriorate and gaps in care lead to worse outcomes.”
He will cover the important role technology (meters, pumps, sensors) plays in managing type 1 diabetes.
“Good tools are available but often are not used properly,” said Dr. Wolfsdorf. “Patient behavior is crucial for successful outcome, and active parental/family/school involvement and support contribute to better glycemic control during adolescence.”
Session Notes: (S31) Type 1 Diabetes in the Pediatric and Adolescent Patient 2:15 pm Saturday in Room 310, repeating (S52) at 3:30 pm Saturday in Room 310 Jay Cohen, MD, will serve as moderator.