Abstract
This chapter considers the issues of health care, insurance, and policies that affect pediatric diabetes management. After reviewing epidemiologic trends in pediatric diabetes, we consider guidelines for treatment and goals of care. Consistent with the social ecological model, we discuss models of pediatric health care and address barriers to health insurance. Diabetes management in the school setting is discussed, along with consideration of laws that impact on how care is delivered in various settings. Finally, international perspectives on these issues are discussed. Continued advocacy including appropriate policy changes is needed to ensure that children and adolescents with diabetes achieve good glycemic control, quality of life, and a future free of health complications.
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American Diabetes Association. (2013). Diabetes Care in the School and day Care Setting. Diabetes Care, 36(Suppl 1), S75–S79.
American Diabetes Association. (2018). 12. Children and adolescents: Standards of medical care in diabetes – 2018. Diabetes Care, 41, S126–S136.
The Australian Children’s Education and Care Quality Authority is the national, independent statutory authority governing the National Quality Framework www.acecqa.gove.au/national-quality-framework/national-law and regulations 2017.
Bratina, N., Forsander, G., Annan, F., et al. (2018). ISPAD clinical practice guidelines 2018: Management and support of children and adolescents with type 1 diabetes in school. Pediatric Diabbetes, 19(Suppl. 27), 287–301.
Cameron, F., Cotterill, A., Couper, J., et al. (2013). Short report: Care for children and adolescents with diabetes in Australia and New Zealand: Have we achieved the defined goals? Journal of Paediatrics and Child Health, 49, E258–E262.
Cameron, F. J., Garvey, J., Hood, K. K., Acerini, C. L., & Codner, E. (2018). ISPAD Clinical Practice Consensus Guidelines 2018. Diabetes in adolescence. Pediatric Diabetes, 19(Suppl 27), 250–261.
Catanzariti, L., Faulks, K., Moon, L., Waters, A. M., Flack, J., & Craig, M. E. (2009). Australia’s national trends in the incidence of type 1 diabetes in 0-14-year-olds, 2000–2006. Diabetic Medicine, 26, 596–601.
Charalampopoulos, D., Hermann, J. M., Svensson, J., et al. (2018). Exploring variation in glycemic control across and within eight high-income countries: A cross-sectional analysis of 64,666 children and adolescents with type 1 diabetes. Diabetes Care, 41(6), 1180–1187.
Chiang, J. L., Kirkman, M. S., Laffel, L. M., & Peters, A. L. (2014). Type 1 diabetes through the life span: A position statement of the American Diabetes Association. Diabetes Care, 37, 2034–2054.
Children and Families Act.2014. Diabetes UK: Diabetes in schools – responsibilities of headteachers, school governors & responsible bodies. www.diabetes.org.UK
Chobot, A., Polanska, J., Brandt, A., Deja, G., Glowinska-Olszewska, B., Pilecki, O., … Jarosz-Chobot, P. (2017). Updated 24-year trend of type 1 diabetes incidence in children in Poland reveals a sinusoidal pattern and sustained increase. Diabetic Medicine, 34(9), 1252–1258.
Clapin, H., Phelan, H., Bruns, L., Jr., et al. (2016). Australasian diabetes data network: Building a collaborative resource. Journal of Diabetes Science and Technology, 10, 1015–1026.
Copeland, K. C., Silverstein, J., Moore, K. R., et al. (2013). Management of newly diagnosed type 2 diabetes mellitus (T2DM) in children and adolescents. Pediatrics, 131, 364–382.
Corathers, S. D., Schoettker, P. J., et al. (2015). Health-system-based interventions to improve care in pediatric and adolescent type 1 diabetes. Current Diabetes Reports, 15, 91.
Dabelea, D., Bell, R. A., D’Agostino, R. B., Jr., et al. (2007). Incidence of diabetes in youth in the United States. Journal of the American Medical Association, 297, 2716–2724.
Dabelea, D., Mayer-Davis, E. J., Saydah, S., et al. (2014). Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. JAMA, 311, 1778–1786.
Danne, T., Phillip, M., Buckingham, B. A., et al. (2018). ISPAD clinical practice consensus guidelines 2018: Insulin treatment in children and adolescents with diabetes. Pediatric Diabetes, 19(Suppl. 27), 115–135.
DiMeglio, L. A., Acerini, C. L., Codner, E., et al. (2018). ISPAD clinical practice consensus guidelines 2018: Glycemic control targets and glucose monitoring for children, ado- lescents, and young adults with diabetes. Pediatric Diabetes, 19(Suppl. 27), 105–114.
Donaghue, K. C., Marcovecchio, M. L., Wadwa, R. P., et al. (2018). ISPAD clinical practice consensus guidelines 2018: Microvascular and macrovascular complications in children and adolescents. Pediatric Diabetes, 19(Suppl. 27), 262–274.
Edwards, D., Noyes, J., Lowes, L., Haf Spencer, L., & Gregory, J. W. (2014). An ongoing struggle: A mixed-method systematic review of interventions, barriers and facilitators to achieving optimal self-care by children and young people with type 1 diabetes in educational settings. BMC Pediatrics, 14, 228.
Eibner, C. Nowak, S. A. (2018, July). The effect of eliminating the individual mandate penalty and the role of behavioral factors. Commonwealth Fund.
Everest, E., Akhtar, S., Sumego, M., et al. (2016). Effectiveness of shared medical appointments versus traditional clinic visits for adolescents with type 1 diabetes. Quality Management in Health Care, 25, 181–184.
Fazeli Farsani, S., van der Aa, M. P., van der Vorst, M. M., Knibbe, C. A., & de Boer, A. (2013). Global trends in the incidence and prevalence of type 2 diabetes in children and adolescents: A systematic review and evaluation of methodological approaches. Diabetologia, 56, 1471–1488.
Ferguson, S. C., Blane, A., Wardlaw, J., et al. (2005). Influence of an early-onset age of type 1 diabetes on cerebral structure and cognitive function. Diabetes Care, 28, 1431–1437.
Foster, N. C., Beck, W., Miller, K. M., Clements, M. A., Rickles, M. R., DiMeglio, L. A., … Olson, B. (2019). GARG SK, for the T1D exchange clinical network, state of type 1 diabetes management and outcomes from the T1D exchange in 2016–2018. Diabetes Technology & Theraputics, 21(2), 66–72.
Gandica, R., & Zeitler, P. (2016). Update on youth-onset type 2 diabetes: Lessons learned from the treatment options for type 2 diabetes in adolescents and youth clinical trial. Advances in Pediatrics, 63, 195–209.
Gaudieri, P. A., Chen, R., Greer, T. F., & Holmes, C. S. (2008). Cognitive function in children with type 1 diabetes: A meta-analysis. Diabetes Care, 31, 1892–1897.
Gesuita, R., Skrami, E., Bonfanti, R., et al. (2016). The role of socio-economic and clinical factors on HbA1c in children and adolescents with type 1 diabetes: An Italian multicentre survey. Pediatric Diabetes, 18(3), 241–248.
Goss, P., Goss, J., Price, D., Gray, L., Paterson, M., Foskett, D., Chambers O’Shannassy, J., Harding, A.. T1D Learning Center, https://www.t1d.org.au, APS, ISPAD.
Hilliard, M. E., Harris, M. A., & Weissberg-Benchell, J. (2012). Diabetes resilience: A model of risk and protection in type 1 diabetes. Current Diabetes Reports, 12, 739–748.
Hilliard, M. E., Powell, P. W., & Anderson, B. J. (2016). Evidence-based behavioral interventions to promote diabetes Management in Children, adolescents and families. The American Psychologist, 71(7), 590–601.
Hood, K. K., Peterson, C. M., Rohan, J. M., & Drotar, D. (2009). Association between adherence and glycemic control in pediatric type 1 diabetes: A meta-analysis. Pediatrics, 124, e1171–e1179.
Hood, K. K., Beavers, D. P., Yi-Frazier, J., et al. (2014). Psychosocial burden and glycemic control during the first 6 years of diabetes: Results from the SEARCH for diabetes in youth study. The Journal of Adolescent Health, 55, 498–504.
IDF. (2017). Diabetes atlas (8th ed.). Brussels, Belgium: International Diabetes Federation.
Imperatore, G., Boyle, J. P., Thompson, T. J., et al. (2012). Projections of type 1 and type 2 diabetes burden in the U.S. population aged <20 years through 2050: Dynamic modeling of incidence, mortality, and population growth. Diabetes Care, 35, 2515–2520.
Inman, M., Daneman, D., Curtis, J., et al. (2016). Social determinants of health are associated with modifiable risk factors for cardiovascular disease and vascular function in pediatric type 1 diabetes. The Journal of Pediatrics, 177, 167–172.
Jackson, C. C., Albanese-O’Neill, A., Butler, K. L., et al. (2015). Diabetes care in the school setting: A position statement of the American Diabetes Association. Diabetes Care, 38, 1958–1963.
Kahkoska, A. R., Shay, C. M., Crandell, J., Dabelea, D., et al. (2018). Association of Race and Ethnicity with glycemic control and hemoglobin A1c levels in youth with type 1 diabetes. JAMA Network Open, 1(5), e181851.
Katz, M. L., Laffel, L. M., Perrin, J. M., & Kuhlthau, K. (2012). Impact of type 1 diabetes mellitus on the family is reduced with the medical home, care coordination, and family-centered care. The Journal of Pediatrics, 160, 861–867.
Katz, L. L., Anderson, B. J., McKay, S. V., et al. (2016). Correlates of medication adherence in the TODAY cohort of youth with type 2 diabetes. Diabetes Care, 39(11), 1956–1962.
Klingensmith, G. J., Connor, C. G., Ruedy, K. J., et al. (2016). Presentation of youth with type 2 diabetes in the pediatric diabetes consortium. Pediatric Diabetes, 17, 266–273.
Lawrence, S. E., Cummings, E. A., Pacaud, D., Lynk, A., & Metzger, D. L. (2015). Managing type 1 diabetes in school: Recommendations for policy and practice. Paediatrics & Child Health, 20, 35–44.
Limbers, C. A., Emery, K., Young, D., & Stephen, M. (2015). Cognitive functioning, metabolic control, and treatment type in youth with type 1 diabetes. Journal of Pediatric Endocrinology & Metabolism, 28, 353–355.
Luyckx, K., Seiffge-Krenke, I., Missotten, L., Rassart, J., Casteels, K., & Goethals, E. (2013). Parent-adolescent conflict, treatment adherence and glycemic control in type 1 diabetes: The importance of adolescent externalising symptoms. Psychology & Health, 28, 1082–1097.
Mahmud, F. H., Elbarbary, N. S., Fröhlich- Reiterer, E., et al. (2018). ISPAD clinical practice consensus guidelines 2018: Other complications and associated conditions in children and adolescents with type 1 diabetes. Pediatric Diabetes, 19(Suppl. 27), 275–286.
Marrero, D. G., Ard, J., Delamater, A. M., Peragallo-Dittko, V., Mayer-Davis, E. J., Nwankwo, R., & Fisher, E. B. (2013 Feb). Twenty-first century Belahioral medicine: A context for empowering clinicians and patients with diabetes: A consensus report. Diabetes Care, 36(2), 463–470.
Mauras, N., Mazaika, P., Buckingham, B., et al. (2015). Longitudinal assessment of neuroanatomical and cognitive differences in young children with type 1 diabetes: Association with hyperglycemia. Diabetes, 64, 1770–1779.
Mayer-Davis, E. K., Lawrence, J. M., Dabelea, D., et al. (2017). Incidence trends of type 1 and type 2 diabetes among youths, 2002–2012. The New England Journal of Medicine, 376, 1419–1429.
Mayer-Davis, E. J., Kahkoska, A. R., Jefferies, C., et al. (2018). ISPAD clinical practice consensus guidelines 2018: Definition, epidemiology, and classification of diabetes in children and adolescents. Pediatric Diabetes, 19(Suppl. 27), 7–19.
Meehan, C., & Silverstein, J. (2016). Treatment options for type 2 diabetes in youth remain limited. The Journal of Pediatrics, 170, 20–27.
Mezquita-Raya, P., Reyes-Garcia, R., Moreno-Perez, O., et al. (2013). Position statement: Hypoglycemia management in patients with diabetes mellitus. Diabetes mellitus working Group of the Spanish Society of endocrinology and nutrition. Endocrinología y Nutrición, 60, 517.e511–517.e518.
Modi, A. C., Pai, A. L., Hommel, K. A., et al. (2012). Pediatric self-management: A framework for research, practice, and policy. Pediatrics, 129, e473–e485.
Nadeau, K. J., Anderson, B. J., Berg, E. G., et al. (2016). Youth-onset type 2 diabetes consensus report: Current status, challenges, and priorities. Diabetes Care, 39, 1635–1642.
Nambam, B., Silverstein, J., Cheng, P., et al. (2016). A cross-sectional view of the current state of treatment of youth with type 2 diabetes in the USA: Enrollment data from the pediatric diabetes consortium type 2 diabetes registry. Pediatric Diabetes, 18(3), 222–229.
Naughton, M. J., Yi-Frazier, J. P., Morgan, T. M., et al. (2014). Longitudinal associations between sex, diabetes self-care, and health-related quality of life among youth with type 1 or type 2 diabetes mellitus. The Journal of Pediatrics, 164, 1376–1383.e1371.
Noser, A. E., Patton, S. R., Van Allen, J., Nelson, M. B., & Clements, M. A. (2016). Evaluating Parents’ self-efficacy for diabetes Management in Pediatric Type 1 diabetes. Journal of Pediatric Psychology, 42(3), 296–303.
Oester, I. M., Kloppenborg, J. T., Olsen, B. S., & Johannesen, J. (2016). Type 2 diabetes mellitus in Danish children and adolescents in 2014. Pediatric Diabetes, 17, 368–373.
Onge, E. S., Miller, S. A., & Motycka, C. (2015). DeBerry A. A review of the treatment of type 2 diabetes in children. Journal of Pediatric Pharmacology and Therapeutics, 20, 4–16.
Papanicolas, I., Woskie, L. R., & Jha, A. K. (2018, Mar 13). Health care spending in the United States and other high-income countries. Journal of the American Medical Association, 319(10), 1024–1039.
Parish, S. L., Shattuck, P. T., & Rose, R. A. (2009). Financial burden of raising CSHCN: Association with state policy choices. Pediatrics, 124(Suppl 4), S435–S442.
Patterson, C. C., Dahlquist, G. G., Gyurus, E., Green, A., & Soltesz, G. (2009). Incidence trends for childhood type 1 diabetes in Europe during 1989–2003 and predicted new cases 2005–20: A multicentre prospective registration study. Lancet, 373, 2027–2033.
Patterson, C. C., Gyurus, E., Rosenbauer, J., et al. (2012). Trends in childhood type 1 diabetes incidence in Europe during 1989–2008: Evidence of non-uniformity over time in rates of increase. Diabetologia, 55, 2142–2147.
Perantie, D. C., Lim, A., Wu, J., et al. (2008). Effects of prior hypoglycemia and hyperglycemia on cognition in children with type 1 diabetes mellitus. Pediatric Diabetes, 9, 87–95.
Persson, S., Dahlquist, G., Gerdtham, U. G., & Steen Carlsson, K. (2013). Impact of childhood-onset type 1 diabetes on schooling: A population-based register study. Diabetologia, 56, 1254–1262.
Pettitt, D. J., Talton, J., Dabelea, D., et al. (2014). Prevalence of diabetes in U.S. youth in 2009: The SEARCH for diabetes in youth study. Diabetes Care, 37, 402–408.
Phelan, H., Lange, K., Cengiz, E., et al. (2018). ISPAD clinical practice consensus guidelines 2018: Diabetes education in children and adolescents. Pediatric Diabetes, 19(Suppl. 27), 75–83.
Pierce, J. S., & Wysocki, T. (2015). Topical review: Advancing research on the transition to adult Care for Type 1 diabetes. Journal of Pediatric Psychology, 40, 1041–1047.
Pihoker, C., Forsander, G., Fantahun, B., et al. (2018). ISPAD clinical practice consensus guidelines 2018. The delivery of ambulatory diabetes care to children and adolescents with diabetes. Pediatric Diabetes, 19(Suppl 27), 84–104.
Prasanna Kumar, K. M., Dev, N. P., Raman, K. V., et al. (2014). Consensus statement on diabetes in children. Indian Journal of Endocrinology Metabolism, 18, 264–273.
Rice, et al. (2018). BMC Health Services Research, 18, 371.
Sarnblad, S., Akesson, K., Fernstrom, L., Ilvered, R., & Forsander, G. (2016). Improved diabetes management in Swedish schools: Results from two national surveys. Pediatric Diabetes, 18, 463–469.
Sarnblad, S., Berg, L., Detlofsson, I., Jonsson, A., & Forsander, G. (2014). Diabetes management in Swedish schools: A national survey of attitudes of parents, children, and diabetes teams. Pediatric Diabetes, 15, 550–556.
Sawyer, B., Cox, C. (2018). How does health spending in the U.S. compare to other countries? Kaiser Family Foundation. Peterson-Kaiser Health Tracker.
Scaramuzza, A., Cherubini, V., Tumini, S., et al. (2014). Recommendations for self-monitoring in pediatric diabetes: A consensus statement by the ISPED. Acta Diabetologica, 51, 173–184.
Schnell, O., Alawi, H., Battelino, T., et al. (2011). Addressing schemes of self-monitoring of blood glucose in type 2 diabetes: A European perspective and expert recommendation. Diabetes Technology & Therapeutics, 13, 959–965.
Semenkovich, K., Patel, P. P., Pollock, A. B., et al. (2016). Academic abilities and glycaemic control in children and young people with type 1 diabetes mellitus. Diabetic Medicine, 33, 668–673.
Sharma, M., Nazareth, I., & Petersen, I. (2016). Trends in incidence, prevalence and prescribing in type 2 diabetes mellitus between 2000 and 2013 in primary care: A retrospective cohort study. BMJ Open, 6, e010210.
Smart, C. E., Annan, F., Higgins, L. A., Jelleryd, E., Lopez, M., & Acerini, C. L. (2018). ISPAD clinical practice con- sensus guidelines 2018: Nutritional management in children and adolescents with diabetes. Pediatric Diabetes, 19(Suppl 27), 136–154.
Silverstein, J., Cheng, P., Ruedy, K. J., et al. (2015). Depressive symptoms in youth with type 1 or type 2 diabetes: Results of the pediatric diabetes consortium screening assessment of depression in diabetes study. Diabetes Care, 38, 2341–2343.
Skinner, T. C., Lange, K. S., Hoey, H., et al. (2018 May). The Hvidoere study GroupTargets and teamwork: Understanding differences in paediatric diabetes centers treatment outcomes. Pediatric Diabetes, 19(3), 559–565.
Sundberg, F., Barnard, K., Cato, A., de Beaufort, C., DiMeglio, L. A., Dooley, G., Hershey, T., Hitchcock, J., Jain, V., Weissberg-Benchell, J., Rami-Merhar, B., Smart, C. E., & Hanas, R. (2017). Managing diabetes in preschool children. Pediatr Diabetes, 0, 1–19.
Tamborlane, W. V., Haymond, M. W., Dunger, D., et al. (2016). Expanding treatment options for youth with type 2 diabetes: Current problems and proposed solutions: A white paper from the NICHD diabetes working group. Diabetes Care, 39, 323–329.
Tran, F., Stone, M., Huang, C. Y., et al. (2014). Population-based incidence of diabetes in Australian youth aged 10-18 yr: Increase in type 1 diabetes but not type 2 diabetes. Pediatric Diabetes, 15, 585–590.
Weinstock, R. S., Drews, K. L., Caprio, S., Leibel, N. I., McKay, S. V., & Zeitler, P. S. (2015). Metabolic syndrome is common and persistent in youth-onset type 2 diabetes: Results from the TODAY clinical trial. Obesity (Silver Spring), 23, 1357–1361.
Weinstock, R. S., Trief, P. M., El Ghormli, L., et al. (2015). Parental characteristics associated with outcomes in youth with type 2 diabetes: Results from the TODAY clinical trial. Diabetes Care, 38, 784–792.
Wolfgram, P. M., Sarrault, J., Clark, S., & Lee, J. M. (2013). State-to-state variability in title V coverage for children with diabetes. The Journal of Pediatrics, 162, 873–875.
Wood, J. R., Miller, K. M., Maahs, D. M., et al. (2013). Most youth with type 1 diabetes in the T1D exchange clinic registry do not meet American Diabetes Association or International Society for Pediatric and Adolescent Diabetes clinical guidelines. Diabetes Care, 36, 2035–2037.
Zeitler, P., Hirst, K., Pyle, L., et al. (2012). A clinical trial to maintain glycemic control in youth with type 2 diabetes. The New England Journal of Medicine, 366, 2247–2256.
Zeitler, P., Arslanian, S., Fu, J., et al. (2018). ISPAD clinical practice consensus guidelines 2018: Type 2 diabetes mellitus in youth. Pediatric Diabetes, 19(Suppl 27), 28–46.
Zeraatkar, D., Nahari, A., Wang, P. W., et al. (2016). Appraisal of clinical practice guidelines for management of paediatric type 2 diabetes mellitus using the AGREE II instrument: A systematic review protocol. Systematic Reviews, 5, 111.
Zhang, L., Ellis, D. A., Naar-King, S., Moltz, K., Carcone, A. I., & Dekelbab, B. (2016). Effects of socio-demographic factors on parental monitoring, and regimen adherence among adolescents with type 1 diabetes: A moderation analysis. Journal of Child and Family Studies, 25, 176–188.
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Fisher, L.K., Vidmar, A.P. (2020). Health Care, Insurance, and School Policy Affecting Diabetes in the Pediatric Population. In: Delamater, A., Marrero, D. (eds) Behavioral Diabetes. Springer, Cham. https://doi.org/10.1007/978-3-030-33286-0_16
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