Everyone in a child’s life—friends, family, caretakers, instructors, and school officials—is impacted when the child has diabetes. Childhood diabetes has wide-ranging psychological and social effects that can affect entire communities. Texas Children’s Hospital uses early intervention, education, and community engagement to enhance care for all kids.
A Complicated Situation
Insulin is insufficient in children with Type 1 diabetes to transport glucose, or sugar, to their cells for energy. This insulin shortage will cause elevated blood sugar levels and, if ignored, can result in diabetic ketoacidosis (DKA), a potentially fatal illness. High blood sugar can cause fatigue, weight loss, increased thirst, and increased urination. Initial flu-like symptoms including nausea, vomiting, and exhaustion may be mistaken for DKA symptoms, which swiftly develop into lethargy, mental status abnormalities, and other symptoms. DKA is a dangerous side effect of diabetes that frequently necessitates hospitalization.
Children with type 1 diabetes place a heavy strain on the healthcare system, their families, and themselves. Children and their families must rapidly pick up a lot of new skills after being diagnosed, such as how to calculate insulin dosages, count carbohydrates, and administer insulin several times a day—all while leading busy, full lives. In order to continuously optimize many facets of diabetes treatment, the Texas Children’s Diabetes and Endocrinology Center established interdisciplinary diabetes care process teams. Both preventing DKA and improving overall diabetes outcomes have significantly improved as a result of the initiative.
Resolving Care Barriers
Five care process teams, each concentrating on a distinct aspect of diabetes care, are supported by the Diabetes and Endocrine Care Center. To improve diabetes care for children, the high-risk, clinical, inpatient, community outreach, and educational groups collaborate.
According to Selorm Adzaku Dei-Tutu, MD, a board-certified pediatric endocrinologist at Texas Children’s Hospital and co-lead of their high-risk diabetes care process team, the high-risk team’s mission is to identify and address the problems, particularly the psychosocial ones, that lead to children repeatedly visiting the hospital with DKA and other diabetes complications.
Diabetes-related psychosocial problems can include low self-esteem, stress, anxiety, sadness, lack of social support, and poor sleep.
According to Dr. Dei-Tutu, the team consists of social workers, diabetes care and education specialists, nutritionists, a community health worker, psychologists, and medical professionals because many problems are psychosocial. A sizable multidisciplinary team works to address the various psychological obstacles that contribute to DKA and uncontrolled diabetes.
Dr. Dei-Tutu mentions a specific patient who benefited from a multidisciplinary care team’s psychosocial support.
“This young woman worked closely with our main campus’s extra care team, which includes a nurse navigator and social worker who collaborate with diabetes providers and the rest of the diabetes care team,” Dr. Dei-Tutu stated. She frequently visited the clinic. She was aware that she may email or leave a message at any time to her team. Her A1C significantly dropped and her DKA episodes ceased with that degree of care and attention.
She even received assistance from the extra care team in applying to colleges and obtaining on-campus housing. She is doing well in college right now.
Children with diabetes, their families, and the general public all benefit when psychosocial variables are taken into account when providing medical treatment.
According to Dr. Dei-Tutu, support services including regular clinic visits, transportation assistance, and appointment reminders help people manage their diabetes journey more effectively.
Exchange of knowledge and best practices
Texas Children’s standardizes care at its diabetes clinic sites while acknowledging that every clinic is different in order to guarantee that all children receive the same high-quality, evidence-based services and tests. Patients’ concerns are addressed by these system-wide initiatives, which include, among many other things, standardizing inpatient diabetes care, pushing technologies like insulin pumps and continuous glucose monitoring, and paying more attention to youngsters who are thought to be at high risk for DKA. These programs have significantly improved patient care and results, and while they may appear slightly different in different places, all staff members and clinicians have the same objective of offering top-notch, compassionate care.
Locally and nationally, the diabetic community may become more cohesive by exchanging best practices and expertise. The Type 1 Diabetes Exchange QI Collaborative Improvement Collaborative (T1D Exchange QI Collaborative), a non-profit organization dedicated to enhancing care and quality of life for individuals with diabetes through quality improvement initiatives, collaborates with Texas Children’s to promote knowledge sharing. More than 60 adult and pediatric diabetes centers across the country are working together on this project.
The T1D Exchange QI’s collaborative nature According to Dr. Dei-Tutu, collaboration enables us to share and learn from quality improvement methods with other centers, including our wrap-around services, depression screening, and initiatives to increase technology adoption. Our work is continuously shared, and we use what we learn from others’ efforts to further assist our patients.
Bringing the Diabetes Community Together
Community diabetes care promotes insurance coverage for diabetic technology, educates families and school nurses, and supports families with diabetes. Events held in a secure, encouraging setting could also fall under this category.
According to Dr. Dei-Tutu, we host a number of unique activities that connect with the type 1 diabetes community and foster camaraderie.
Numerous online social groups for kids and parents of kids with diabetes are hosted by Texas Children’s. Celebrity guests with type 1 diabetes are a feature in some social groups. In others, a representative from the Texas Children’s Diabetes and Endocrine Care team gives a lecture. All of them have engaging conversations about a variety of subjects, such as insulin pump problems, diabetes burnout, and exercise management.
Additionally, the hospital offers a number of unique events throughout the year, such as the Diabootes Bash, a fall event that takes place around Halloween and involves patients, family, and staff dressing up as characters, and the Diabetes Spring Fling, an annual outdoor event for families. Games, face painting, food trucks, crafts, and more are all part of the program. They also take part in events and fundraisers organized by the community, like the ADA and Breakthrough T1D walks. These gatherings are intended to help people with diabetes connect with others who also have the disease and to build a feeling of community between families and the Texas Children’s diabetes care team.
For additional information, parents and families who are interested in attending an event should visit the Texas Children’s website.
Call Texas Children’s Diabetes and Endocrine Care Center at 832-822-2778 to make an appointment or have your child screened for diabetes.
