January 17, 2012

In 2010, it was estimated that 215,000 people in the U.S. under age 20 had type 1 or type 2 diabetes. By managing their blood glucose and getting proper nutrition, exercise and support, children and young adults with this condition can learn to manage their diabetes and live happy, healthy lives.

Continuity of care is very important, which is why the outpatient diabetes education program at CAMC has started seeing pediatric diabetic patients who have been inpatients at CAMC Women and Children’s Hospital, or have been referred from the WVU Physicians of Charleston pediatric endocrinology office.

“We give individualized education based on the patient’s nutritional needs for his or her age to help promote normal growth and development,” said Jenny McMillion, a registered dietitian and certified diabetes educator with the CAMC outpatient diabetes education program. “Medical nutrition therapy is important in helping prevent diabetes, manage existing diabetes and prevent, or at least slow, the rate of development of diabetes complications.”

“Our diabetic patient population includes about 400-500 kids,” said Kevin Lewis, RN, MSN, CDE, nurse practitioner in the WVU Physicians of Charleston pediatric endocrinology office. “When we see newly diagnosed outpatients, we give them basic education and then refer them to the CAMC program for nutrition education.” If patients are diagnosed in the hospital, they first see Amy Spadafora, a registered dietitian and certified specialist in pediatric nutrition at Women and Children’s Hospital. Lewis and Spadafora work together with nurses and other pediatric health care providers to care for inpatient diabetics.

“I give them the ‘survival skills’ education to help them know what to eat, how things are going to work and what to do if their blood glucose goes low. It’s not about changing everything they do, but teaching them how to adapt,” Spadafora said.

When patients leave the hospital but still need diabetes management, they are referred to the outpatient program.

“I strongly encourage them to go. Having this opportunity is great for continuity of care, because we know that they are getting consistent messages about taking care of themselves,” she said.

“The arrangement has worked out very well for us,” Lewis said. “The program accommodates our patients quickly, and we all meet to discuss the curriculum on a regular basis so we are teaching the same things.”

When patients enter the outpatient diabetes program, they set goals to help meet their individual nutritional needs. The whole family is involved in the education process.

“As energy requirements change with age, physical activity and growth rate, an evaluation of the patient’s nutrition therapy plan is recommended at least every year,” McMillion said.

Rebecca Kozak, 16, is a type 1 diabetic who worked with McMillion in the outpatient program. She said the classes helped her to become more familiar with good nutrition and prepared her for getting an insulin pump.

“The classes definitely help. She taught me about eating right, high and low starch foods and long-lasting carbs, and also about the insulin pump. It wasn’t as hard as I thought it would be, and she went through things as many times as I needed,” Kozak said.

Kozak added that she doesn’t let her diabetes get in the way of school and other things. She has attended Camp Kno-Koma, a camp for kids with diabetes, for 10 years and is working to become a leader in training. She also organized a diabetes awareness event at her school.

Beth McMillion, 13, is also a type 1 diabetic who participated in CAMC’s outpatient program. She said that the program helped her with knowing what to eat, how to put meals together and learning about an insulin pump. While she’s still waiting to start on her pump, she found the educational program very helpful.

For more information about the CAMC outpatient diabetes education program, visit camc.org/diabetes, call (304) 388-5555 or email diabetes@camc.org.

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