Consistent Use of Diabetes Technology Across Multiple Environments Benefits Youth with Diabetes
San Francisco, California
June 9, 2019
In recent years, diabetes technology has evolved at a rapid pace, and the use of insulin pumps and continuous glucose monitoring (CGM) systems has grown tremendously. To foster a more active role in diabetes management among youth, professionals encourage consistent utilization of monitoring tools across multiple environments. A professional interest group presentation entitled “Diabetes Technology Use in Schools, Camps, and Emergency Rooms,” focused on the use of diabetes technology for children and adolescents in a variety of settings, today at the American Diabetes Association’s® (ADA’s) 79th Scientific Sessions® at the Moscone Center in San Francisco.
Coordination of Care Among Families, Schools and Health Care Providers
Type 1 diabetes (T1D) must be managed 24 hours a day, 7 days a week, including during the many hours children and adolescents spend at school. Short- and long-term diabetes-related complications can be delayed or prevented with proper management. In the 2015 Diabetes Care in the School Setting: A Position Statement of the American Diabetes Association, recommendations for managing the disease are outlined, including the importance of ensuring that diabetes care teams work in partnership with the child’s family and school staff to achieve successful and safe diabetes management at school.
“In order to keep students with diabetes safe at school, prevent complications and ensure full participation in all activities, proper diabetes care must be attended to throughout the day including during school hours and all school-related activities,” said Anastasia Albanese-O’Neill, PhD, ARNP, CDE, clinical assistant professor and director of diabetes education and clinic operations at the University of Florida, College of Medicine, Division of Pediatric Endocrinology; and co-author of the ADA’s Position Statement. “In today’s world, diabetes management includes supporting the student’s use of a variety of diabetes technologies, including insulin pumps, continuous glucose monitors, Bluetooth insulin pens and meters, and hybrid closed loop insulin delivery systems. To be successful, a strong partnership to coordinate care among the family, school and diabetes health care provider is essential.”
Dr. Albanese-O’Neill recommends that school nurses and staff responsible for diabetes care be familiar with diabetes technology devices, and the diabetes care team should support their training and education. In addition, although resources have been developed and are available online to assist with training, the community of diabetes health care professionals must commit additional attention to improving these materials and ensuring they are available to all school health staff.
Extending the Advantages of Consistent Diabetes Technology Use to ADA Camp Programs
When children attend diabetes camps, the goal is for them to manage their diabetes with the same tools they use at school, home or daycare in a safe and fun environment, and to gain more self-management skills and independence. Across the ADA’s more than 60 diabetes camp programs, approximately 75% of campers in the summer of 2018 used an insulin pump at camp, and 15% were using a CGM.
The ADA recognizes the evolution of diabetes technology and encourages campers to grow in their diabetes self-care and self-management of diabetes. In the Diabetes Technology section of the ADA’s 2019 Standards of Medical Care in Diabetes, experts advise that “real-time continuous glucose monitoring should be considered in children and adolescents with type 1 diabetes, whether using multiple daily injections or continuous subcutaneous insulin infusion (insulin pumps), as an additional tool to help improve glucose control and reduce the risk of hypoglycemia. Benefits of continuous glucose monitoring correlate with adherence to ongoing use of the device.”
To stay ahead of the rapidly advancing diabetes technology, the ADA hosted a conference in December 2017 with forty-one stakeholders, including a small group of leaders across the ADA’s camp network, the Diabetes Education and Camping Association (DECA), industry representatives, ADA Youth and Family Initiative staff, and the Helmsley Charitable Trust. At the conference, the ADA created a living document for Best Practices for the use of Diabetes Technology at Summer Camps, which contains recommendations for the incorporation and use of medical technology at summer camps for children with diabetes. Outlined in the living document is information and usage instructions for insulin pumps and CGM currently on the market.
“We purposely chose the term ‘living document’ rather than calling this a ‘guideline,’ as technology is moving so quickly that this document requires frequent updates as products change, become FDA approved and are available,” explained Lowell Schmeltz, MD, FACE, an associate professor at the Oakland University William Beaumont School of Medicine, chairman of Camp Midicha (Michigan), and a member of the ADA Youth Strategies Committee.
One study of CGM use at a diabetes camp presented at the 2017 conference demonstrated that the use of advanced diabetes technology can help campers manage low blood sugar levels. Campers using CGM had a 74% lower relative risk of having at least one severe hypoglycemic episode (blood glucose <50) during their week at camp, compared to controls (14% vs. 38%; OR: 0.26 (95% CI: 0.09, 0.73); P = 0.0012). There was no significant difference on average blood sugar or incidence of significant hyperglycemia.
Dr. Schmeltz emphasizes that the use of diabetes technology at camp extends beyond blood sugar management. “During camp, we foster independence and self-confidence, and we aim for the child to be more knowledgeable and capable of contributing to their daily and ongoing diabetes management.”
To speak with Dr. Albanese-O’Neill or Dr. Schmeltz, please contact the ADA Press Office on-site at San Francisco’s Moscone Convention Center on June 7-11, by phone at 415-978-3606 or by email at SciSessionsPress@diabetes.org.
The American Diabetes Association’s 79th Scientific Sessions, the world’s largest scientific meeting focused on diabetes research, prevention and care, will be held June 7-11, 2019, at the Moscone Center in San Francisco, California. Nearly 15,000 leading physicians, scientists, health care professionals and industry representatives from around the world are expected to convene at the Scientific Sessions to unveil cutting-edge research, treatment recommendations and advances toward a cure for diabetes. During the five-day meeting, attendees will receive exclusive access to more than 850 presentations and 2,000 original research presentations, participate in provocative and engaging exchanges with leading diabetes experts, and can earn Continuing Medical Education (CME) or Continuing Education (CE) credits for educational sessions. The program is grouped into eight thematic areas: Acute and Chronic Complications; Behavioral Medicine, Clinical Nutrition, Education and Exercise; Clinical Diabetes/Therapeutics; Epidemiology/Genetics; Immunology/Transplantation; Insulin Action/Molecular Metabolism; Integrated Physiology/Obesity; and Islet Biology/Insulin Secretion. Gretchen Youssef, MS, RDN, CDE, President of Health Care and Education, will deliver her address, “It’s All About Access!,” on Saturday, June 8, and Louis H. Philipson, MD, PhD, FACP, President of Medicine and Science, will deliver his lecture, “Precision Medicine—Addressing the Many Faces of Diabetes,” on Sunday, June 9. Join the Scientific Sessions conversation on social media using #ADA2019.
About the American Diabetes Association
Every day more than 4,000 people are newly diagnosed with diabetes in America. Nearly 115 million Americans have diabetes or prediabetes and are striving to manage their lives while living with the disease. The American Diabetes Association (ADA) is the nation’s leading voluntary health organization fighting to bend the curve on the diabetes epidemic and help people living with diabetes thrive. For nearly 80 years the ADA has been driving discovery and research to treat, manage and prevent diabetes, while working relentlessly for a cure. We help people with diabetes thrive by fighting for their rights and developing programs, advocacy and education designed to improve their quality of life. Diabetes has brought us together. What we do next will make us Connected for Life. To learn more or to get involved, visit us at diabetes.org or call 1-800-DIABETES (1-800-342-2383). Information is available in English and Spanish. Join the fight with us on Facebook (American Diabetes Association), Twitter (@AmDiabetesAssn) and Instagram (@AmDiabetesAssn).
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