Diabetes Care for Kids: Management, Resources, and Quality Care for Pediatricians

The continued search for improved technology and medications for type 1 and type 2 diabetes means that it remains important to stay on top of the latest trends in pediatric diabetes care. Along with excellent clinical care, pediatricians can also offer families reassurance and helpful lifestyle advice to make kids’ lives both healthy and fun. We’ll cover a brief overview of the clinical, practice management, and community support your practice can provide to support kids with this chronic condition.

Updates in Clinical Practice for Diabetes Care

"The future is ahead of us, and will not be easy, but we need to find better remedies to prevent complications that we are seeing right now.” Dr. Sonia Caprio, MD, Yale University School of Medicine

As childhood obesity rates rise in the U.S., concerns for childhood type 2 diabetes rise, too. Pediatricians will need tools, support, and advocacy to provide the appropriate care for both type 2 and type 1 diabetes. In a conference for the American Diabetes Association, Dr. Sonia Caprio of the Yale University School of Medicine discussed the future of diabetes care in children and the close link between childhood obesity and type 2 diabetes. 

Trends in diabetes also point to a disparate rise in diabetes in minority children, highlighting a need for intersectional healthcare for these communities. Data suggests that minority children are less likely to receive technological innovations in diabetes care, even in high-income countries like the U.S., which can lead to deteriorating HbA1c patterns. 

Early and aggressive detection of type 1 and 2 diabetes alongside provider education is instrumental to providing the best care available for children and the best possible outcome, hopefully with lifelong positive effects.

The great news is that technology and medicine continue to develop innovative methods to track and manage diabetes, making the management of the disease simpler and more accessible to many families. From Bluetooth insulin pumps to a medication that’s required just once a week, pediatricians and families have more options than ever to make diabetes management a simple and hassle-free part of a child’s life.

Resources

Professional resources for diabetes care might include continuing education, podcasts, journals, and books, such as these from the ADA. Your practice may also want to pursue physician or staff training on subjects closely related to diabetes diagnosis in children, such as food insecurity, obesity, and social determinants of health (SDoH). See our previous post on this topic for more resources.

Diabetes prevention is also a key component to care. While the CDC’s existing programs for diabetes focus on adults 18 and older, their recommended resource, the AMA’s Diabetes Prevention Toolkit, has certain tools like letter templates and questionnaires that can be used or adapted for children. The kit includes informational resources in English and Spanish for prediabetes patients, prevention, and professional education for clinical staff. The Juvenile Diabetes Research Foundation (JDRF) has similar resources available on type 1 diabetes.

Type 1 & Type 2 Diabetes Well Care for Children

While diabetes can be well managed with a healthy lifestyle and with medication, prevention and early detection are tools for pediatricians treating children with diabetes. Here are the top ways pediatricians manage diabetes in their patient populations:

• Gestational diabetes screening. While the birthing parent may be tested 6-12 weeks after their infant is born by their PCP, it’s helpful to note a history of gestational diabetes since babies born of these pregnancies may be more likely to be obese and develop type 2 diabetes later in life.

• Screening and early detection. While type 2 diabetes and obesity are closely tied, both type 1 and type 2 diabetes in children in normal weight ranges is possible and not always easy to detect. Qualified screenings such as those from CHADIS are helpful, and it’s always worth asking parents about less obvious symptoms that could indicate diabetes according to the AAP, such as excessive thirst, a history of malnutrition, or trouble with toilet training.

• Population health and recall. Practice managers will want to keep an eye on the data in your community to take proactive steps in caring for these patients. Is diabetes, whether type 1 or 2, common in your patients? If so, a recall program may be a great tactic to ensure families are on the right track with their care plan. Learn how to run a report to find diabetes patients in PCC EHR here.

• Lifestyle management. With the right support from their families, medical home, and community, kids can lead active and normal lives. Resources for families are many -- practices can offer educational resources from HealthyChildren.org, such as information on obesity, referral to specialists like pediatric endocrinologists, and of course information on healthy living with type 1 and type 2 diabetes. Families should also learn about the importance of the flu shot for diabetes patients.

• Community. Patients may find reassurance and learn coping skills by talking with family members, other children, or even healthcare providers who share their disease. Families can contribute and join research and community efforts to better treat and understand diabetes with organizations such as the ADA and the JDRF. There are also great programs out there for kids to help them learn to care for their bodies and lead active, confident lives -- check out Camp Sweeney, a summer program designed for type 1 diabetes patients focused on resilience, confidence, and medical management. There are many more camps available at www.diabetescamps.org. 

When planning your practice’s approach to diabetes management, try to balance the clinical aspect of care with the practice management and patient engagement pieces of the puzzle. After all, pediatricians who listen to their patients can often find simple ways of getting excellent resources to the families who need them, whether that is early detection or community-level support. 

In the end, excellent diabetes care is just one part of a great preventive care program. We hope you found something to add to your preventive care plans for this year. Not sure how else to grow your preventive care program? It’s the most important work pediatricians do, and it’s critical for kids’ health and for practice revenues. Learn how to build a rock-solid foundation in preventive medicine with this webinar hosted by PCC’s Pediatric Solutions Director Chip Hart, where he’ll show how you can get started, refresh your skills, and better connect you to families.