Children with Diabetes
Letting Kids be Kids
With all the hype about weight-related Type 2 Diabetes, Type 1 Diabetes has fallen through the media cracks. But with one in every 250 children being diagnosed with the disease each year, Markham Stouffville Hospital’s Pediatric Diabetes Clinic offers quality of life to these kids.
By Paula Anderton
There’s still no cure for Type 1 Diabetes, but there’s reason to hope. Researchers know more about the disease than ever, the first step in finding a cure. In the meantime, the Pediatric Diabetes Clinic at Markham Stouffville Hospital uses an approach to treating children with diabetes that puts the emphasis where it belongs, on the children.
The Pediatric Diabetes Clinic, or PDC, currently has 350 patients, with 40-50 new kids joining the program each year. The PDC, founded by endocrinologist Dr. Robert Ehrlich, is based on a treatment model he established at Sick Kids Hospital 20 years ago. It’s is a kind of one-stop-shopping, as Alanna Landry, a registered nurse and certified pediatric diabetes educator at the PDC, explains, “We have dietitians, social workers, doctors and nurses all under one roof. It’s the best bang for your buck to see all the health care professionals in one place at one time.”
Patients at the clinic visit every three months for a full assessment. They see social workers, dietitians, doctors and nurse-educators all in the same day. The clinic staff go out of their way to create a welcoming atmosphere for their patients, who will be part of the clinic’s ‘family’ for years to come. They are also committed to developing incentive programs for the kids and different traveling presentations they can take to schools to educate students and teachers.
Support is Vital
The format of the PDC is designed to help children with diabetes have normal, healthy lives. And the support and education parents get at the clinic are vital to this aim. For the parents of kids with diabetes, the pressures of coping with the disease can be crushing.
The regimen for children with Type 1 Diabetes and their families is tough. The daily grind for these kids involves three to 4 insulin injections, with 4-5 blood sugar tests that are painful ‘pokes’ of their fingers to draw samples. One month’s worth of medicine and supplies costs about $300-$400, and they aren’t covered by OHIP, not even the insulin.
Some of the equipment can also be costly. The insulin pump, a fairly new device that releases insulin continuously under the skin, is one of the options that can be offered to adolescents with diabetes. But the unit costs about $6,000, also not covered by OHIP.
Apart from financial pressure, diabetes creates unique parenting challenges, especially with little children. Older kids and adolescents with diabetes are encouraged to take an active role in their treatment regimen. But toddlers with diabetes are another story. Says Marilyn Fry, a registered clinical dietitian at the PDC: “You offer them three, well- balanced meals and three snacks a day at regular times, but you cannot force your toddler to eat. It does mean the sugar’s a lot more variable with toddlers, and we have to accept that. If we thought it would harm the child we wouldn’t do it.”
Older kids can be reasoned with, and that means a lot more flexibility in their diets. Says Fry, “People think kids with diabetes can’t have cake. We work-in cake, we work-in ice cream, birthday parties, Halloween, chocolates, anything can fit in. Maybe you can’t have it exactly when you want it and maybe you can’t have the whole cake, but you sure can have a piece of cake and some icing with it without getting sick or going to the hospital.”
The PDC puts the emphasis on balance, and letting kids be kids. They also emphasize that the complications that can arise from Type 1 Diabetes, like amputations, infections and kidney failure, are largely preventable. Says Landry, “We do tell parents about the risks and complications, but we don’t want them being fearful every day. The latest study shows that a 75% decrease in complications can be achieved by reducing overall blood sugars over time in Type 1 Diabetics.”
Landry stresses common sense in managing diabetes. Parents have to stay ‘hands-on’ to ensure their kids’ blood sugars are stable, and they have to set an example that promotes nutrition and exercise. “It’s really a model of a healthy lifestyle for anybody, diabetic or not.”
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