Panel to explain why smarter is better in pediatric diabetes

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3 minutes

New approaches, new research, and new trials are producing smarter, more effective approaches to diagnosing and managing diabetes in children, adolescents, and young adults. Working smarter starts with recognizing that not all diabetes is type 1 or type 2.

“In most peoples’ minds, even in some physicians’ minds, when you say ‘diabetes,’ they ask if it’s type 1 or type 2,” explained Mustafa Tosur, MD, FAAP, Associate Professor of Diabetes and Endocrinology at Baylor College of Medicine, Texas Children’s Hospital, and Children’s Nutrition Research Center. “And there are multiple types of atypical diabetes that don’t fit either one.”

Mustafa Tosur, MD, FAAP
Mustafa Tosur, MD, FAAP

Dr. Tosur will open the symposium, Trending Topic and Smart Solutions in Pediatric Diabetes, on Monday, June 23, from 3:15–4:15 p.m., in Room W183 BC of the McCormick Place Convention Center. On-demand access to recorded presentations will be available to registered participants following the conclusion of the 85th Scientific Sessions, from June 25–August 25.

Monogenic diabetes, caused by a single genetic mutation, is among the most familiar types of atypical diabetes. But not all monogenic diabetes is the same. Maturity onset diabetes of the young (MODY) has multiple forms and genetic etiologies. Other atypical diabetes forms include ketosis-prone diabetes, syndromic diabetes, and mitochondrial diabetes.

“We have better understanding of the etiologies of atypical diabetes and better risk prediction,” Dr. Tosur said. “We’ve come a long way in understanding how different atypical forms respond to different treatments with continued progress and multicenter collaborations. ”

The same is true of exercise. Guidelines universally recommend physical activity, but fear of hypoglycemia stops many patients from following this recommendation.

Dessi Zaharieva, PhD, CEP, CDCES
Dessi Zaharieva, PhD, CEP, CDCES

“We have seen in pediatrics and adults that fear of hypoglycemia continues to be one of the leading barriers to exercise,” said Dessi Zaharieva, PhD, CEP, CDCES, Instructor in Pediatrics Endocrinology and Diabetes at Stanford University School of Medicine. “One of the most important areas is to provide resources and structured education around how to safely exercise, maybe even before those barriers have developed. That is something we are doing at Stanford as standard of care.”

Part of that standard is simplifying exercise guidelines and information. Dr. Zaharieva helped develop exercise resources on DiabetesWise.org as a neutral, patient-oriented information source. A new clinical trial is assessing website use and impact on patients’ physical activity levels and clinical outcomes.

“Diabetes guidelines often need to be individualized,” she said. “We can’t have a blanket statement. We need guidance for many different people at different stages of their diagnosis. Novice exercisers versus elite athletes may have very different responses to exercise and also different needs.”

Jenise C. Wong, MD, PhD
Jenise C. Wong, MD, PhD

Online information is just one way technology is changing diabetes. Virtual support groups and shared medical appointments can transform care as patients discover they are not alone in diabetes.

“There may be a lack of knowing anyone else who has diabetes,” explained Jenise C. Wong, MD, PhD, Professor of Pediatric Endocrinology at the University of California, San Francisco, and Director of Quality and Safety for Pediatric Endocrinology at Benioff Children’s Hospital. “We hear this a lot from caregivers. People heal a bit just by sharing their stories.”

Busy schedules and travel distance can hamper in-person visits, so researchers launched a virtual program across multiple sites in California.

“It is practicality and meeting patients and families where they are,” Dr. Wong explained. “We wanted to bring in families from different communities to interact without requiring them to come in person, which can be logistically impossible. A lot of our effort is focused on education on diabetes technology, not just from facilitators but from participants troubleshooting with each other. We don’t specifically call it peer support and mentoring, but it’s what they’re doing. The ultimate question is: Will that ultimately lead to improvement in their glycemic outcomes and overall wellbeing?”

Extend your learning on the latest advances in diabetes research, prevention, and care after the 85th Scientific Sessions conclude. From June 25–August 25, registered participants will have on-demand access to presentations recorded in Chicago via the meeting website.