Background and Aims

Providing care for young children with type 1 diabetes requires special training and experience since the diabetes care in children is different from that in adults. Furthermore, many general pediatricians may not have the most up to- date knowledge about diabetes care.

The delivery of diabetes care in an efficient way can improve the diabetes outcome in the long term.

Methods

We evaluated obstacles which can interfere in providing an optimal care focusing on different aspects:

1- Staffing and personnel

2- Rescue medications

3- Technology utilization

4- Outcome evaluation

Results

1- Trained staff who have experience in managing pediatric diabetes should be utilized instead of referring visits and phone calls to general pediatric personnel. The team should include dietitians and certified diabetes educators to help the current pediatric endocrinologists

2- Rescue medications (insulin and glucagon) should be available in outpatient settings for immediate use

3- Immediate testing of Hemoglobin A1c ( HbA1c), training to utilize insulin pumps and continuous glucose monitor systems (CGMs), and evaluating families readiness for technology use should be performed at diagnosis

4- Diabetes care outcomes should be evaluated by HbA1c levels, fluctuation of recorded glucose levels, prevention of hypoglycemia and quality of life

Conclusions

The optimal delivery of pediatric diabetes care in the society plays a major role in improving diabetes outcome for children. Early utilization of technology by dedicated well- trained staff can improve the metabolic control and allow better quality of lives, not only for children with diabetes, but also their families.