The Diabetes Technology Clinic - A Better Way Forward

Diabetes is one of the most common long-term childhood diseases. The Centers for Disease Control and Prevention estimates that one in three American children born today will develop diabetes during their lifetime.

At the National Philoptochos Children’s Medical Fund Luncheon in October of 2013, $136,900 was awarded in grants for innovative research programs to pediatric hospitals and to organizations with special programs that care for children with critical and life threatening illnesses.

One of the grant recipients was University Hospital’s Rainbow Babies and Children’s Hospital in Cleveland, OH, receiving $21,000 for their Diabetes Technology Clinic. Our guest blogger this week is Sarah A. MacLeish, DO, Assistant Professor of Pediatrics, Pediatric Endocrinology at Rainbow Babies and Children’s Hospital. Sarah gives us an overview of new technology being used today as well as how the Clinic is using this technology to help families monitor their children’s diabetes care.

The Rainbow Pediatric Diabetes Technology Clinic was started in November 2012 to help our patients understand and utilize the many areas of diabetes technology available.

Insulin pumps have been around for over 30 years, but newer pumps with more features are quickly becoming available.  Pumps have calculators that help families give the correct insulin dose.  Insulin doses are different for different times of the day and different meals, making insulin dose calculators very helpful.  Insulin pumps allow for very small, accurate doses of insulin which is especially important for young patients who require small doses. Information from the insulin pumps can be downloaded, giving doctor’s information about patient’s blood sugar, insulin dose, and carbohydrate intake, which can then be used to accurately adjust insulin doses. 

Continuous glucose monitors (CGMs) are a newer diabetes technology. Within the past year, more accurate and smaller glucose sensors have become available in the United States.  CGMs involve a very small wire, about the size of a hair, that stays under the skin to measure glucose levels.  Attached to the wire is a small plastic glucose transmitter that sits on top of the skin and collects all the glucose information.  CGMs measure glucose every five minutes, giving a much better picture of what is happening to a patient’s blood sugar than just four to six blood sugar checks in a day.  CGMs can also set off an alarm to alert a patient about a high or low blood glucose. 

Very recently, the first step toward the artificial pancreas was approved for use in the United States.  This system involves an insulin pump and a CGM that work together.  If the CGM detects the glucose is low, it will alarm.  If no one responds to the alarm (such as if someone is sleeping very soundly or if they are unconscious), the insulin pump will stop delivery of insulin for up to two hours. 

At the Rainbow Diabetes Technology Clinic, we place CGMs on patients to use for one week and then we use the information to more accurately prescribe insulin doses.  Patients are also able to try different types of CGMs to see if having a CGM of their own, to use all the time, ia helpful.  We also help educate and train patients to use their insulin pumps and CGMs to their full ability.

Another area of focus is making sure our underserved patients – those on Medicaid insurance or without insurance – are able to use insulin pumps and CGMs to the same degree as their peers.  Last year we piloted a program involving the use of text messaging to communicate with the diabetes care team and were able to help seven underserved children start using insulin pumps.  The program also involved much more frequent diabetes appointments with education from the diabetes nurse and dietician.

One patient who participated in this program had always wanted an insulin pump.  Our patient and the patient’s  mom came to six different appointments to learn how to use the pump and frequently sent text messages to communicate with the doctor.  The patient’s blood sugar average went from 240 to 170, which is a big drop, and the patient is having a much easier time taking care of their diabetes.

We are so grateful for the grant from Philoptochos.  This grant is helping us to purchase CGMs and supplies, and will also help provide patients without insurance with supplies for their insulin pump.  A new part of the program we are just starting with the support of Philoptochos is to use a special computer program that will allow us to download information from almost all of the different types of blood sugar meters and insulin pumps.  This program requires less manpower from medical assistants, giving medical assistants more time for other important tasks.  In addition, the information will all be web-based, so if a patient calls with an emergency outside of office hours, the information from their pump or meter will be available anywhere.  This will also be available for patients to download from their home, so they can send the diabetes care team at Rainbow their blood sugar results between appointments. The grant will also help further train and educate our diabetes nurses in the fast-changing field of diabetes technology. 

Thank you Philoptochos for all of your help in improving Rainbow’s Diabetes Technology Clinic!

The Easter Gyro Fundraiser - A Fan Favorite

The Dormition of the Virgin Mary Greek Orthodox Church Philoptochos Chapter in Winchester, Virginia holds an annual Easter gyro sale to the delight of their parishioners and the local community. It is the Chapter’s largest fundraiser and it allows them to assist those in need both locally and nationally.

The Easter gyro booth generates about $3,000, a large amount for a small parish and community. The majority of the proceeds go towards Social Services to help individuals and families who are struggling and need the support of Philoptochos.

The Chapter began the fundraiser a couple of years ago. Chapter President Maria Boyer said, “I wanted a fundraiser that involved food as the profit margin is better than other fundraisers for us.” The Philoptochos Chapter also runs their annual festival gyro stand. A team of ladies is involved in the preparation both before and during the fundraisers, procuring the essential food items and assembling the gyros. As you can imagine, it’s not just the parish that looks forward to these fundraisers but also the larger Winchester community.

Philoptochos is synonymous with baking but what if your Chapter did something a little bit different, like this Chapter in Winchester, VA. How about selling lobster rolls, cheeseburgers, or perhaps apple, cherry, or lemon meringue pie? The possibilities are truly endless but it’s best to cater to your parish and the surrounding community and create a fundraiser that will stick in their mind year after year.

Happy first day of spring everyone!

-Vivian Siempos

Child’s Way - Offering Much Needed Care for Children with Complex Medical Needs

At the National Philoptochos Children’s Medical Fund Luncheon in October of 2013, $136,900 was awarded in grants for innovative research programs to pediatric hospitals and to organizations with special programs that care for children with critical and life threatening illnesses.

One of the grant recipients was the Children’s Home of Pittsburgh & Lemieux Family Center, receiving $10,000 towards their Child’s Way program. Child’s Way provides a vital alternative or supplemental care for children with acute and chronic medical needs, giving kids the care they need while also offering educational and social activities. Our guest blogger today is Kelsey L. Williams, MPH of The Children’s Home of Pittsburgh and Lemieux Family Center, who gives a comprehensive look into Child’s Way’s history and services.

The work of The Children's Home of Pittsburgh began in 1893 as The Pennsylvania Children's Home Society. The organisation was founded to care for orphaned children and place them in permanent homes. The Adoption Program still thrives today after 120 years of operation. In the 1980s and 1990s, The Children's Home added two distinct, innovative medical programs with the purpose of furthering the continuum of care for children. The Pediatric Specialty Hospital (formerly Transitional Infant Care) opened in 1984 to provide a new model of sub-acute care for infants and their families; in 2007 this model was expanded to include patients up to age 21 with a wide variety of diagnoses. In 1998, Child’s Way was established as yet another model of alternative care for pediatric patients – a Pediatric Extended Care Center; in other words, Child’s Way® is a day care for children with complex medical needs.

The Children's Home established Child's Way as the first Pediatric Extended Care Center (PECC) in Pennsylvania to fill a significant gap in pediatric healthcare services with an innovative program – an alternative and supplement to home care for children with complex medical needs, ages birth to 21. The program provides medically skilled, daytime child care and therapeutic services, allowing families to maintain their employment and health insurance, or continue their education, while their children receive appropriate care. As the only alternative to home care nursing, Child’s Way offers coordinated services in one easy location, which helps ease the sense of isolation many of these families experience and relieves some of the demand created by the nursing shortage. We are the only PECC serving children in Allegheny County.
 

Staffed by pediatric registered nurses and child care associates, providing comprehensive care, the activities, interaction with other children, and therapies at Child’s Way ensure that each child receives the physical, emotional and intellectual stimulation that he or she needs to live a fuller, happier life and reach developmental milestones. 

• Child’s Way has served over 350 children and their families 
• 75 individual children were served in fiscal year 2013 
• 32 new children were admitted to Child’s Way in 2013 (A program high!) 
• In 2013, 10 children transitioned to traditional classroom settings which is the ultimate goal of the program, whenever medically and developmentally possible for a child

The programs of The Children’s Home & Lemieux Family Center continue to adapt and change in response to new needs in the community and are able to thrive by the generosity of organizations, foundations and individuals, committed to helping this region’s children and families. The grant provided by the Greek Orthodox Ladies Philoptochos Society allows The Children’s Home to provide scholarships to Child’s Way families, to ease the financial burden of providing the necessary care required by their child, which makes a tremendous impact.
 
For more information about Child’s Way or The Children’s Home of Pittsburgh & Lemieux Family Center, visit our website: www.childrenshomepgh.org.