A Window Into The World of the paediatric diabetes team who support children and young people with diabetes at St. Mary’s Hospital Trust IOW.
Submitted by Chad Hamilton, Paediatric Diabetes Dietitian, St. Mary’s Hospital Trust IOW.
The professionals that make up the paediatric diabetes team on the Isle of Wight are passionate not only about the health of the children that access our service, but they also care deeply about their overall wellbeing. As a team, we go out of our way to ensure that despite having a long-term condition, they still get experience and enjoy all the important milestones that are essential for having a normal childhood.
Our team consists of two specialist paediatric consultants, a specialist paediatric diabetes dietitian & nurse, along with a paediatric psychologist and our administrator who keeps the ship running smoothly. Together, we try to work synergistically to offer the best possible support to all the children and young people with type 1 / type 2 diabetes or any other genetic condition that affects their blood glucose control.
The one thing that we all love about paediatric diabetes is that you get to follow these children through all stages of adolescence and help them circumvent challenges that such a diagnosis can pose. We celebrate all their successes whether that is passing their exams, landing their 1st summer job or finally hitting a new subscriber milestone on their twitch or YouTube account. Alternatively, we also do our best to offer them realistic solutions to the problems they will undoubtedly encounter. Being young a person in today’s world is just riddled with numerous road blocks, whether it be anything from maintaining good grades to just fitting in at school. Now try adding the extra pressure of having to take a medication every time you need to eat something and/or prick your finger. This can makes you stand out when all you want to do is blend in with the rest of your peers.
As a team we try to meet these challenges head on by offering easier and more realistic ways for our children and their families to manage diabetes. Technology is changing so rapidly and with it comes newer and more efficient ways for children to manage their blood glucose levels. Whether that be through very intuitive insulin pumps, new insulin generations that allow for more flexibility or more recently smart phone friendly continuous glucose monitoring (CGM) to help reduce finger prick tests. As children grow, their needs change and as a service we change with them.
We try to do this by giving them more control or say on how they want to manage their diabetes. ‘You don’t want to have to test so often at school…fine…let’s try this or maybe you don’t like taking your insulin in front of your friends, but you still want to spontaneously hang out at the fish & chip shop and then do a sleep over… no problem let’s try that.’ Every child is different, so sometimes it takes a lot trial and error before we find something that actually works for them. Their mental well-being comes first and as long as they’re safe, everything else will eventually fall into place.
Does this mean that sometimes they might not have the best blood glucose numbers from time to time? Of course, but it’s not about that; instead it’s revolves around gradually building their confidence so that they can make decisions, learn from them and take action if needed.
COVID-19 has been a scary time for not only us as professionals, but also for our families on the island. However, one good thing that has come out of it is that we are now able to do video clinics. With these clinics our families can upload their insulin pumps, blood glucose meters and CGM to our secure database from the comfort of their homes. We then see them via a webcam to talk about how they are managing and any changes they think need to be made as it relates to their diabetes care. As professionals we try to make the parents and children lead the consultation and if we have any further suggestions on nutrition, exercise, coping strategies or insulin, then we will offer our advice and the rationale behind it. We are really looking forward to using this more often especially for our teenagers as they are often so busy with school, friends and just life really. As a result they sometimes don’t really want to make it to clinic especially seeing that we see them a minimum of 4 times per year. With video clinics we can now come to them either on a computer or a smart device.
The paediatric diabetes team at St Mary’s Hospital is comprised of a group professionals that not only enjoy helping families meet the challenges of managing diabetes in the modern world, but who also enjoy watching our young people mature into the best possible versions of themselves by the time they transition to adult’s service.