BOSTON Youngsters with diabetes who have poor blood sugar control are at higher risk of developing serious complications such as heart disease and blindness later in life. For some time health professionals have been seeking cost-effective ways to help keep these children on track. A new study by researchers at Joslin Diabetes Center shows that adding a case manager, or a "care ambassador," to keep in touch with the child and the family between medical visits, help coordinate the child's diabetes care and provide additional educational services, can make a significant difference in helping the child and the family control blood sugar levels.

The two-year randomized clinical study, published in the October issue of the journal Pediatrics, was led by Lori Laffel, M.D., M.P.H., chief of the Pediatric and Adolescent Unit of Joslin Diabetes Center in Boston. In the study of 299 Joslin patients with type 1 (insulin-dependent) diabetes who were ages 7 to 16, Dr. Laffel and her colleagues found that the youngsters who received care ambassador support services were over three times as likely to improve their blood sugar levels than other "control" youngsters who received standard multidisciplinary care. The trial compared three treatment programs: a care ambassador alone, a care ambassador plus a psychoeducational component, and standard multidisciplinary care.

"Caring for youngsters with type 1 diabetes is challenging for families," Dr. Laffel said. "The patients require multiple daily insulin injections or insulin pump therapy, frequent blood sugar checks, meal planning, and care with exercise as it must also be factored into the treatment. Then, there are the frequently changing school and activity schedules and the child's growing body that need to be considered in managing the diabetes."

About Joslin's Care Ambassador Program

Each new pediatric patient with diabetes who comes to Joslin in Boston for care is assigned a care amba
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Contact: Marge Dwyer
marjorie.dwyer@joslin.harvard.edu
617-732-2415
Joslin Diabetes Center
17-Oct-2003

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