Dealing with diabetic children in school

Scientists from the University of Wellington in New Zealand suggest glucose testing meters be more stylish so that children with type I diabetes are not embarrassed when they use the meters in school.

A student with Type I is quite likely to be the only student using medical equipment in class in checking blood glucose levels. They may feel self-conscious when they pull out the meter--plus a test strip and a lancet device.

A recent article claims that this is especially true for girls although no studies are cited to confirm this view. The scientists think that this problem can be helped by having glucose meters with jewelery-inspired design.

What the kids want

The scientists interviewed some girls aged 13-24 with type 1 diabetes to find out what sort of design requirements they wished in a meter. One would think there might be interviews with females who are all children. However, their responses were interesting in that they wanted such things as a well-functioning meter, one that blended in with other everyday items and did not draw attention to itself. Wouldn't a glucose meter designed to be stylish and like jewelry call attention to itself?

The researchers decided to have young people themselves tackle the design problem. 28 participated. Ideas included a watch. As a recent Digital Journal article points out such a device already exists but is rather costly.

Gillian McCarthy, author of the study, said: “The feedback we got from the teenagers was positive. We weren’t looking to create finished medical devices to go to market, but wanted to promote discussion and show the importance of respecting their psychosocial requirements”. While it may be important to design medical instruments that children use in public in a way that can lessen any possible embarrassment, many children may simply want to test for blood glucose in private and not in public view.

Insulin another problem to tackle

Type I diabetics not only need to test their glucose levels regularly but also need to inject themselves with insulin using a pen or a syringe. The pens no doubt look less formidable and could be stylish. However, most diabetics probably would prefer to do the injection in private rather than public.

The Canadian Pediatric Society has a website that lists a set of rules for Canadian schools. In part, the document says:Schools must provide all students with a clean, convenient and safe area for diabetes self-care, and respect students’ personal preference for privacy. Self-care tasks include blood glucose monitoring and the administration of insulin via injection or insulin pump. The level of autonomy will vary based on age and the individual child. The youngest children will need school personnel to provide all aspects of glucose monitoring and insulin administration, while older elementary school students are likely to need supervision only. As students mature, they are typically more able to provide self-care. School personnel should be identified and trained within the school to support students as needed.

Providing type I diabetic children in schools with the facilities and care suggested in the above recommendations should be a pressing priority for communities looking to promote better healthcare among school children.

Scientists able to make cells able to release insulin a possible breakthrough in diabetes therapy

Both type 1 and type 2, or adult onset, diabetes involve either an inability to produce or properly process the insulin necessary to control blood sugar levels.

Diabetes or Diabetes Mellitus (DM) is a group of metabolic diseases in which there will be high levels of blood sugar over a long period if the disease is not controlled. If the high blood levels persist there can be serious long-term complications including heart problems, stroke, kidney failure, foot ulcers and eye damage. The disease can be due to the pancreas not producing enough insulin or the failure of the body to able to use the insulin produced. Type 1 is a result of failure of the pancreas to produce enough insulin. Treatment is through insulin injections. The cause is not known. Type 2 involves insulin resistance in which the body does not respond to insulin. However, as the disease develops there may be a shortage of insulin as well. Although it often occurs in obese people or those who do not exercise enough, there can be other causes. The third type is gestational diabetes in which there are high blood sugar levels in pregnant women. Usually the problem corrects itself after birth. Type 1 is managed with insulin injections. In the early stages Type 2 may be helped by diet and exercise but often oral medications are used as well. Insulin can also be used, especially in later stages or if moral medications cease working.

The lack of insulin or the ability to process it and the resultant inability to control blood sugar levels is linked to malfunctioning or failing beta cells in the pancreas. So far scientists have not been able to produce replacement cells in the lab that would be able to function correctly. In a recent breakthrough, a team of researchers at the Salk Institute believe they have solved the problem:The Salk scientists found a protein switch – one of several transcription factors in a beta cell – called ERR-gamma that makes the lab-grown cells more responsive to glucose and gets them releasing insulin at a normal rate. This ERR-gamma switch appears to be the master regulator for maturing glucose-responsive beta cells.

Transcription factors are described here. The researchers were able to test their discovery by transplanting mature beta cells into Type 1, insulin dependent, diabetic mice with the ERR-gamma switch on. Two months after this transplantation, about half of the diabetic mice showed normal blood glucose levels.

The research shows quite promising results but further tests and human trials will be necessary. It may be possible one day to produce the insulin-producing beta cells from stem cells taken from patients. In the best case scenario, Type 1 diabetics may be able to control their blood sugar levels without having to constantly inject insulin. In some patients the disease might be virtually eliminated. The full paper describing the research can be found in Cell Metabolism

Source Salk Institute.