Type I Diabetes in Adolescents

1. Get Pumped? Use of Continuous Subcutaneous Insulin Infusion (SCII) BY ADOLESCENTS WITH TYPE I DIABETES TO OBTAIN OPTIMAL MANAGEMENT OF THE DISEASE AND ACHIEVE A BETTER QUALITY OF LIFE Vanguard University Jan Schlimmer Kathy Thiermann John Wu

3. Types of Diabetes

4. Type 1 Diabetes Management

5. What is Insulin

6. Diabetic Complications

8. Cells stop responding to insulin or the pancreas stops producing insulin

10. Type 2- Although the pancreas produces insulin, the body’s utilization of insulin is poor or inadequate(insulin resistance).Treated with diet, exercise, oral medication and/or subcutaneous insulin injections.

11. Gestational- Increased blood glucose during pregnancy, usually temporary.Focus of this project is on Type 1 DM

13. Subcutaneous Insulin Injections

14. Multiple Daily Injections of Insulin (MDII)

15. Continuous Subcutaneous Insulin Infusion (CSII) via an insulin pump

16. Diet

18. Controls the level of glucose in the blood by regulating the production and storage of glucose.

19. Needed to convert glucose into energy.

21. Macrovascular Complications: Coronary Artery Disease, Cerebrovascular disease, and peripheral vascular disease

23. Hyperglycemia Elevated blood glucose levels

24. Hypoglycemia Low blood sugar levels. Signs and symptoms of progressive hypoglycemia include sweating, tremor, anxiety, irritability, palpitations, headache, mental dullness and sudden fatigue. Can progress to confusion and mental disturbances, unconsciousness, seizures and death.

26. Formed in a non-enzymatic pathway by hemoglobin's normal exposure to high plasma levels of glucose.

28. Type I Diabetes in Adolescents

29. Adolescent Challenges in Managing Type 1 DM

31. Statistics 23.6 million children and adults in the United States have diabetes.

33. Approximately one in every 400 to 600 children are adolescents with Type 1 Diabetes.

35. Social pressures to engage in unhealthy behaviors

36. Erratic school and activity schedules, diet, stress, and depression

37. Lack of sufficient diabetes knowledge and skills to manage the disease (Viklund and et al, 2007).

39. Less likely to follow diabetic treatment regimen due to social pressures

40. Want to be in charge of their own lives and create their own identities(A. Thomas, 1997)

42. lower rates of hypoglycemia

43. less daily glucose variables

44. improved clinical outcomes

47. Comparison

49. The OmniPod manufactured by Insulet Corporation

51. Comparison

52. Comparison

53. Comparison

54. WHICH ONE WE CHOSE…

55. OMNIPOD INSULIN MANAGEMENT SYSTEM The OmniPod SystemThe OmniPodThe Personal Diabetes Manager (PDM)

57. Automated priming & cannula insertion

58. Integrated FreeStyle® blood glucose meter, bolus calculator, food reference library

60. Eliminates tubing and corresponding snagging and disconnecting

61. Provides patients with discreet insulin delivery and freedom of movement for daily activities and sports

63. Integrates a FreeStyle blood glucose meter, bolus calculator and food reference library

64. Bright LCD backlit screen and light-port at testing strip site for ease of use in dark settings

65. Stores, displays and downloads insulin delivery, blood glucose and carbohydrate records

67. First Stage – Initial Inquiry

68. Second Stage – Pre-Training /Preparation/In-Person Training

69. Stage Three – Continuing Education

71. A positive attitude towards diabetes management

72. An understanding of the insulin pump and how it operates

74. OmniPod’s online service provides information about the disease process and how the device assists adolescents to control their Type 1 diabetes, while not compromising their daily life style but enhancing their quality of life.

77. In-depth Training: Go far beyond “basics” when you follow detailed instructions on changing the Pod, testing your blood glucose and using the PDM’s advanced settings.

78. Diabetes Resources: Read helpful sections on nutrition, exercise, handling sick days, being away from home and avoiding highs and lows. The adolescent should review the Pre-Training Preparation section before meeting the trainer.

81. The adolescent’s diabetes management will be evaluated by the healthcare provider and the adolescent as to how the OmniPod has improved the adolescent’s quality of life.

83. Baker, LR, Burton, JR., and Vieve, PD. Principles of Ambulatory Medicine Sixth edition(1183). Philadelphia, PA: Liptincott Williams & Wilkins: 2003

84. Cersosimo, E. (2003). To Pump or Not to Pump. Diabetes Care , 967.

85. George, C. (2009). Future trends in diabetes management. Nephrology Nursing Journal, 477-483.

86. E. Muller-Godeffroy, S. T. (2009). Education and Psychological Aspects Investigation of Quality of Life and Family Burden Issues During Insulin Pump Therapy in Children with Type I Diabetes Mellitus- a large-scale multicenter pilot study. Diabetic Medicine , 493-501.

87. Melville, B. (2005). The insulin pump: why not use it for every type1 Diabetic patient?. Critical Care Nursing Quarterly, 28(4), 370-377.

89. Viklund, G., Rudberg, S., and Wikblad, K.F. (2007). Teenager with diabetes: Self-management education and training on a big schooner. International Journal of Nursing Practice. 13, 385-392

90. Webb, K. (2006) Use of insulin pump for diabetic management. MEDSURG Nursing, 15(2), 61-94

91. Weinzimer, S., Ahern, J., Doyle, E., Vincent, M., Dziura, J., Steffen, A., et al. (2004). Persistence of Benefits of Continuous Subcutaneous Insulin Infusion in Very Young Children With Type 1Diabetes; A Follow-up Report. Pediatrics, 114 (6), 1601-1605.

92. Ziemberg, T. (2001). The Medtronic MiniMed certified pump trainer manual. Sylmar, CA:MedtronicMiniMed, INC.