Family Teamwork Guides Pediatric Care

Dr. Brown with a patient and her newborn baby

Throughout the month of August, we will be sharing important milestones from Joslin’s rich history. More than a century after its creation, Joslin continues its legacy as an internationally recognized diabetes treatment and research institution. This month we are celebrating the talented and dedicated individuals who have contributed to and continue to focus on our mission of preventing, treating and curing diabetes.

Tom Zubricki and his children engaging in educational medical playJoslin’s pediatric program offers exceptional expertise to young patients of all ages, from infants to teenagers and into early adulthood. Family teamwork is vital, and Joslin’s family- centered approaches — validated by research findings — are among the most comprehensive in the world.

Joslin also is a key player in setting pediatric care standards. Approximately 90 percent of pediatric patients at Joslin have type 1 diabetes. Until recently, many were hospitalized during the first week after onset. “With our New Onset Program, we often can teach diabetes management skills to families on an outpatient basis, saving the child the distress of being in the hospital,” says Lori Laffel, M.D., M.P.H., who heads the Pediatric,
Adolescent and Young Adult Section.

Families learn how to incorporate the child’s care into everyday life. “The greatest way to normalize the life of a child with diabetes is by frequently monitoring blood glucose,” says Dr. Laffel. “Diabetes is not a doit- yourself condition. Persons of all ages do best with support and avoidance of isolation. We know from research that children whose care is managed with family teamwork do the best, with respect both to glycemic control and quality of life.”

Today at Joslin, child-life specialists use coaching methods such as therapeutic art and medical play. The Zubricki family, whose two children have type 1 diabetes, enjoy a Joslin diabetes card game, a fun format to learn about their care, guided by Jennifer Griffin, M.S., C.C.L.S. “We explain how taking good care of their diabetes today will also help them be strong and healthy tomorrow,” says Cynthia Pasquarello, B.S.N., R.N., C.D.E., nurse manager and educator.

Each family has a “care ambassador,” who provides personalized support during and between visits. Joslin’s research shows this type of follow-up care results in better blood glucose control and fewer hypoglycemic episodes, emergency room visits and hospitalizations.

Joslin’s insulin-pump program for pediatric patients is the largest in the world, with more than half using a pump, some as young as six months old. The Young Adult Support Program addresses the social and psychological challenges that can derail diabetes routines in the older teen and young adult years. It also helps young adults transition to adult care.

About 10 percent of Joslin’s pediatric patients have type 2 diabetes, largely associated with excess weight. Joslin’s new Childhood Weight Management Program aims to identify children at risk and intervene early on.

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