In recent years, diabetes technology has evolved at a rapid pace.
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 and, even this summer as they head off to day camp, and pharmacists can counsel patients and their parents about using these items while away.
One study of CGM use at a diabetes camp presented at the American Diabetes Association (ADA) 2017 Scientific Sessions demonstrated that the use of advanced diabetes technology can help campers manage low blood sugar levels. In that study, campers using a continuous glucose monitor (CGM) had a 74% lower relative risk of having at least one severe hypoglycemic episode 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.
In a press release based on a presentation at the ADA's 2019 Scientific Sessions, 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, noted 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.” 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.”
In the release, 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 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.
“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 A“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.”
Albanese-O'Neill A, Schmeltz L, Wood J. Diabetes Technology Use in Schools, Camps, and Emergency Rooms. Presented at: American Diabetes Association’s® (ADA’s) 79th Scientific Sessions®. June 7-11. San Francisco, California.