Methods for achieving stable normoglycemia during an educational camp for youth with type 1 diabetes mellitus
Stan De Loach, Ph.D., CDE Certified Diabetes Educator and Clinical Psychologist in independent practice México, Distrito Federal, México
For children and adolescents with recent-onset DM1 to learn to quickly and safely achieve normoglycemia (71—99 mg/dl) and glycemic stability (MAGE score £ 95), using self-directed learning methods, insulin analogues, reduced concentration of dietary CHO, and ad libitum physical activity and SMBG, during an educational camp.
A 5-person international multidisciplinary team managed time, task, territory, technique, and technology boundaries, while responding to the educational and emotional needs of 9 Campers (8—17 years of age [11.8 ± 2.6]), with average diabetes duration of 1.62 years (± .88), during a residential 57-hour (3-day/2-night) diabetes camp.
Campers chose foods from meal buffets, calculated lispro insulin doses, and exercised and monitored BG at will. SMBG values documented in each Camper's combined glucose/ketone monitor furnished statistical data.
Mean arrival and departure BG was 209 mg/dl (± 101.5) and 87 mg/dl (± 23), respectively [P less than .0025].
Mean 3-day BG (95 mg/dl ± 21) and MAGE score (66 ± 27) validated stable euglycemia.
Integrating self-directed diabetologic education, basal/preprandial insulin therapy with analogues, elective physical activity and SMBG, and reduced concentration of dietary CHO rapidly and safely established routinely normal mean daily glycemic levels and stability in this sample.