Health Care, Insurance, and School Policy Affecting Diabetes in the Pediatric Population
This chapter considers the issues of health care, insurance, and policies that affect pediatric diabetes management. After reviewing epidemiologic trends in pediatric diabetes, we consider guidelines for treatment and goals of care. Consistent with the social ecological model, we discuss models of pediatric health care and address barriers to health insurance. Diabetes management in the school setting is discussed, along with consideration of laws that impact on how care is delivered in various settings. Finally, international perspectives on these issues are discussed. Continued advocacy including appropriate policy changes is needed to ensure that children and adolescents with diabetes achieve good glycemic control, quality of life, and a future free of health complications.
KeywordsChildren Adolescents Type 1 diabetes Type 2 diabetes Clinical care Treatment guidelines Health policy Laws
- The Australian Children’s Education and Care Quality Authority is the national, independent statutory authority governing the National Quality Framework www.acecqa.gove.au/national-quality-framework/national-law and regulations 2017.
- Charalampopoulos, D., Hermann, J. M., Svensson, J., et al. (2018). Exploring variation in glycemic control across and within eight high-income countries: A cross-sectional analysis of 64,666 children and adolescents with type 1 diabetes. Diabetes Care, 41(6), 1180–1187.PubMedPubMedCentralCrossRefGoogle Scholar
- Children and Families Act.2014. Diabetes UK: Diabetes in schools – responsibilities of headteachers, school governors & responsible bodies. www.diabetes.org.UK
- Chobot, A., Polanska, J., Brandt, A., Deja, G., Glowinska-Olszewska, B., Pilecki, O., … Jarosz-Chobot, P. (2017). Updated 24-year trend of type 1 diabetes incidence in children in Poland reveals a sinusoidal pattern and sustained increase. Diabetic Medicine, 34(9), 1252–1258.PubMedCrossRefGoogle Scholar
- Edwards, D., Noyes, J., Lowes, L., Haf Spencer, L., & Gregory, J. W. (2014). An ongoing struggle: A mixed-method systematic review of interventions, barriers and facilitators to achieving optimal self-care by children and young people with type 1 diabetes in educational settings. BMC Pediatrics, 14, 228.PubMedPubMedCentralCrossRefGoogle Scholar
- Eibner, C. Nowak, S. A. (2018, July). The effect of eliminating the individual mandate penalty and the role of behavioral factors. Commonwealth Fund.Google Scholar
- Fazeli Farsani, S., van der Aa, M. P., van der Vorst, M. M., Knibbe, C. A., & de Boer, A. (2013). Global trends in the incidence and prevalence of type 2 diabetes in children and adolescents: A systematic review and evaluation of methodological approaches. Diabetologia, 56, 1471–1488.PubMedCrossRefGoogle Scholar
- Foster, N. C., Beck, W., Miller, K. M., Clements, M. A., Rickles, M. R., DiMeglio, L. A., … Olson, B. (2019). GARG SK, for the T1D exchange clinical network, state of type 1 diabetes management and outcomes from the T1D exchange in 2016–2018. Diabetes Technology & Theraputics, 21(2), 66–72.CrossRefGoogle Scholar
- Goss, P., Goss, J., Price, D., Gray, L., Paterson, M., Foskett, D., Chambers O’Shannassy, J., Harding, A.. T1D Learning Center, https://www.t1d.org.au, APS, ISPAD.
- IDF. (2017). Diabetes atlas (8th ed.). Brussels, Belgium: International Diabetes Federation.Google Scholar
- Limbers, C. A., Emery, K., Young, D., & Stephen, M. (2015). Cognitive functioning, metabolic control, and treatment type in youth with type 1 diabetes. Journal of Pediatric Endocrinology & Metabolism, 28, 353–355.Google Scholar
- Mahmud, F. H., Elbarbary, N. S., Fröhlich- Reiterer, E., et al. (2018). ISPAD clinical practice consensus guidelines 2018: Other complications and associated conditions in children and adolescents with type 1 diabetes. Pediatric Diabetes, 19(Suppl. 27), 275–286.PubMedPubMedCentralCrossRefGoogle Scholar
- Marrero, D. G., Ard, J., Delamater, A. M., Peragallo-Dittko, V., Mayer-Davis, E. J., Nwankwo, R., & Fisher, E. B. (2013 Feb). Twenty-first century Belahioral medicine: A context for empowering clinicians and patients with diabetes: A consensus report. Diabetes Care, 36(2), 463–470.PubMedPubMedCentralCrossRefGoogle Scholar
- Mezquita-Raya, P., Reyes-Garcia, R., Moreno-Perez, O., et al. (2013). Position statement: Hypoglycemia management in patients with diabetes mellitus. Diabetes mellitus working Group of the Spanish Society of endocrinology and nutrition. Endocrinología y Nutrición, 60, 517.e511–517.e518.CrossRefGoogle Scholar
- Naughton, M. J., Yi-Frazier, J. P., Morgan, T. M., et al. (2014). Longitudinal associations between sex, diabetes self-care, and health-related quality of life among youth with type 1 or type 2 diabetes mellitus. The Journal of Pediatrics, 164, 1376–1383.e1371.PubMedPubMedCentralCrossRefGoogle Scholar
- Noser, A. E., Patton, S. R., Van Allen, J., Nelson, M. B., & Clements, M. A. (2016). Evaluating Parents’ self-efficacy for diabetes Management in Pediatric Type 1 diabetes. Journal of Pediatric Psychology, 42(3), 296–303.Google Scholar
- Sawyer, B., Cox, C. (2018). How does health spending in the U.S. compare to other countries? Kaiser Family Foundation. Peterson-Kaiser Health Tracker.Google Scholar
- Sundberg, F., Barnard, K., Cato, A., de Beaufort, C., DiMeglio, L. A., Dooley, G., Hershey, T., Hitchcock, J., Jain, V., Weissberg-Benchell, J., Rami-Merhar, B., Smart, C. E., & Hanas, R. (2017). Managing diabetes in preschool children. Pediatr Diabetes, 0, 1–19.Google Scholar
- Wood, J. R., Miller, K. M., Maahs, D. M., et al. (2013). Most youth with type 1 diabetes in the T1D exchange clinic registry do not meet American Diabetes Association or International Society for Pediatric and Adolescent Diabetes clinical guidelines. Diabetes Care, 36, 2035–2037.PubMedPubMedCentralCrossRefGoogle Scholar
- Zhang, L., Ellis, D. A., Naar-King, S., Moltz, K., Carcone, A. I., & Dekelbab, B. (2016). Effects of socio-demographic factors on parental monitoring, and regimen adherence among adolescents with type 1 diabetes: A moderation analysis. Journal of Child and Family Studies, 25, 176–188.PubMedCrossRefGoogle Scholar