Michael Yafi, United States of America

University of Texas in Houston Pediatric Endocrinology

Presenter Of 3 Presentations

MULTIDISCIPLINARY APPROACH ADDRESSING POOR COMPLIANCE WITH THERAPY IN CHILDREN WITH TYPE 1 DIABETES MELLITUS.

Session Name
HUMAN FACTOR IN THE USE OF DIABETES TECHNOLOGY
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
10:17 - 10:18

Abstract

Background and Aims

In treating adolescents with Type I Diabetes Mellitus who are non-compliant with treatment, it is important to address both the medical aspects of management (blood sugar checks, insulin administration, carbohydrate counting) and the underlying social and psychological issues leading to noncompliance. Interventions that focus on emotional, social and family processes have shown good effects on Hb A1c control

Methods

We reviewed the multidisciplinary approach used to evaluate children with poorly controlled type 1 diabetes mellitus in an outpatient clinic setting. Patients and families were offered a variety of services depending on the needs and risk factors identified during the outpatient clinic visit; these included personal/group psychological therapy, social work evaluation and in rare cases, child protective service referrals.

Results

We identified 46 patients with Type I Diabetes Mellitus who were at least 10 years old with a HbA1c at 10% or above. Twenty five percent of them received psychology/psychiatry evaluation, 70% received social work evaluation to address social stressors and family conflicts while 5% were referred to child protective service

Conclusions

Exploring the psychological and social factors in pediatric diabetes is an essential step in improving adherence to optimal management and better disease outcome.

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CARDIOVASCULAR RISK AND TYPE 2 DIABETES MELLITUS RISK IN OBESE CHILDREN

Session Name
HUMAN FACTOR IN THE USE OF DIABETES TECHNOLOGY
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
10:18 - 10:19

Abstract

Background and Aims

Childhood obesity remains the most important risk factor of developing type 2 diabetes and cardiovascular diseases. In the U.S.A, the Center of Disease Control and Prevention (CDC) estimates that greater than one third of the children and adolescents were overweight or obese.

In recent years, cases of pediatric type 2 diabetes in children have been diagnosed more frequently at younger ages than previously seen.

Pediatric obesity and type 2 diabetes are more likely to continue into adulthood.

The objective of this study is to report the association of obesity in children 18 years old or younger with type 2 diabetes, dyslipidemia and hypertension.

Methods

The study population consisted of all patients seen in a pediatric endocrinology clinic. An analysis of ICD10 diagnosis codes was performed for a two- year period from 2015 to 2016, to evaluate the association of diagnoses of obesity and abnormal weight gain with type 2 diabetes and other co-morbidities.

Results

Of 189 overweight, obese or morbidly obese patients identified, twenty six patents (13%) had dyslipidemia, three (less than 1%) had type 2 diabetes and 3 (less than 1 %) had hypertension

Conclusions

Early diagnosis and management of diabetes, hypertension and dyslipidemia in obese children is essential. The pediatric obesity epidemic has allowed adult-type pathologies to evolve in the pediatric population.

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SOCIAL AND PSYCHOLOGICAL ASPECTS RELATED TO POOR DIABETES CONTROL IN CHILDREN

Session Name
HUMAN FACTOR IN THE USE OF DIABETES TECHNOLOGY
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
10:19 - 10:20

Abstract

Background and Aims

Adolescents with Type 1 Diabetes Mellitus demonstrate poorer adherence to treatment regimens than other pediatric age groups . Nonadherence is tightly linked to suboptimal glycemic control, increasing morbidity, and risk for premature mortality. The aim of this study is to investigate the reasons for noncompliance.

Methods

We identified 46 patients with Type I Diabetes Mellitus who were at least 10 years old with a HbA1c at 10% or above. We reviewed the problems identified related to poor compliance

Results

On average, patients had Type 1 Diabetes Mellitus for 5 years. The mean Hgb A1C at the first visit during the study period was 11.3%. About 24% of the patients were hospitalized for Diabetic Ketoacidosis during the study period. About 10% of the patients’ parents separated or divorced either 6 months before or during the study period ,15% of the patients moved and 10% of children changed schools during the study period. One patient experienced the death of a 1st degree relative during the study period. About 10% of the patients experienced other events categorized as life stressors during the study including having a parent with a chronic illness, having a sibling with a prolonged PICU stay, the birth of a sibling and failing classes.

Conclusions

Exploring the psychological and social factors in pediatric diabetes is an essential step in improving adherence to optimal management and better disease outcome.

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