The demands of diabetes

demands of diabetes

Serving the youngest and most vulnerable

Serving the youngest

Doing what can be done

Trina's type 1 diabetes was diagnosed when she was 11 months old.

She did not like it one little bit, not the pricks, not the injections, not the limits on what she could eat, and especially not the visits to the diabetes doctor. Things got better last year when pediatric endocrinologist Inger Hansen (pictured above with another patient) prescribed an insulin pump. Trina started laughing more, sleeping through the night, and waiting patiently while her mother changed the pump’s insulin cartridges.

This year, when the diabetes service that Hansen directs at Emory-Children’s Center (ECC) started a toddler clinic, doctor visits became something to look forward to. Trina, now 3, could play under supervision with other children her age while her mother participated in educational programs with other parents.

Clinicians at the center were surprised then when Trina did not show up for clinic and her mother stopped calling nurse practitioner Megan Consedine for advice. After the second missed clinic visit, Consedine called her.

The mother was embarrassed, apologetic. Trina’s father had abandoned the family and did not support the child, but when Medicaid discovered that he had insurance, they removed Trina from their rolls. Trina’s mother had been able to pay for some insulin but, well, not as much as before.

Consedine tried to keep the alarm out of her voice as she asked Trina’s mother to please bring her little girl in right away, assuring her that “Emory will give you all the insulin she needs for as long as it takes until this is straightened out.

Diabetes is an expensive disease for patients, with insulin alone often costing $160 per month and lancets, strips, and other paraphernalia another $200 to $300. Diabetes is expensive also for Emory Healthcare. Although insurance (when patients have it) provides limited reimbursement for physician visits, it does not cover diabetes classes or the hours educators spend each week on the phone with parents. 

But such support is vital to managing diabetes in children, which is why Hansen insists on it for the 1,500 to 1,800 kids seen each year in the ECC diabetes clinic.

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