Living with Diabetes: One Child’s Perspective

In honor of American Diabetes Month, CHOC Children’s patient Ava Hata sheds insight on living with the disease. Ava, who is 11, was diagnosed with Type 1 diabetes when she was just 18 months old. She and her mom Rebekah, who founded TIDModsquad, are active advocates for patients and families, with Ava striving to be a positive role model for others.

How did you learn to manage your disease?

I remember the first time I pricked myself. I was about 4 years old, and I hated being dependent on other people to prick my finger. I snuck into my bedroom and did it based on what I had observed my parents doing. After that day, the momentum of learning to do it all by myself really took off. And now, after living with Type 1 diabetes for many years, I have an instinct for what I need to do. And while it may seem absurd at times, my instinct has worked in my favor. I have learned what to do and when to do it.

What do you like about your CHOC team?

I love being treated at CHOC by its endocrinology and diabetes team. The nurses are a pleasure to talk to, and Dr. Reh is the best!  She is and always will be my favorite endocrinologist. She’s been taking great care of me since I was little.

What are your hobbies?

I love being around animals. I ride horses and train diabetic alert dogs. I have my self-trained diabetic alert dog, Bruin, who has opened so many doors of opportunity. One cool moment was when I took my dog to see Dr. Bhangoo and got to spend time telling him how Bruin gives alerts on my highs and lows.

tips for kids with Type 1 diabetes
CHOC patient Ava and her self-trained diabetic alert dog, Bruin, share tips for kids with Type 1 diabetes.

In addition to training, I love to show dogs. Other interests include history and literature, as well as building all sorts of objects, from playhouses to terrariums.

How do you manage pursuing all of your interests in spite of living with a chronic condition, and what advice do you have for others?

Honestly, I believe you will always find a way to do what you love. Just keep walking forward, and everything will work out.

What else would you want people to know about living with diabetes?

First of all, people need to understand that it’s not simple and although you think there is a “control” with diabetes, there isn’t — and won’t be until there’s a cure. I’d also really like people to know that I am just like them in the sense that each of us has our differences, including responsibilities. It’s important to accept others and not discriminate against them.

I also want people to know there are numerous support groups, including the one my mom and I founded. It’s nice to connect with others who are going through something similar. You become an instant family!

tips for kids with Type 1 diabetes
Ava and her self-trained diabetic alert dog Bruin.

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U.S. News Names CHOC One of the Nation’s Best Children’s Hospitals

From treating the most complicated cases of epilepsy and repairing complex urological conditions, to curing cancer and saving premature lives, CHOC Children’s physicians and staff are committed to delivering the highest levels of safe, quality care. That commitment has earned CHOC its most recent accolade:  inclusion on the coveted U.S. News & World Report’s Best Children’s Hospitals rankings.   CHOC ranked in eight specialties: cancer, neonatology, neurology/neurosurgery, pulmonology, orthopedics, gastroenterology and GI surgery, diabetes and endocrinology, and urology, which earned a “top 25” spot.

U.S. news

According to U.S. News, the Best Children’s Hospitals rankings are intended to help parents determine where to get the best medical care for their children. The rankings highlight the top 50 U.S. pediatric facilities in 10 specialties, from cancer to urology. Of the 183 participating medical centers, only 78 hospitals ranked in at least one specialty. For its list, U.S. News relies on extensive clinical and operational data, including survival rates, clinic and procedure volume, infection control measures and outcomes, which can be viewed at http://health.usnews.com/best-hospitals/pediatric-rankings. An annual survey of pediatric specialists accounts for 15 percent of participants’ final scores.

“The Best Children’s Hospitals highlight the pediatric centers that offer exceptional care for the kids who need the most help,” says U.S. News Health Rankings Editor Avery Comarow. “Day in and day out, they offer state-of-the-art medical care.”

Dr. James Cappon, chief quality and patient safety officer at CHOC, points to the survey as an invaluable tool for him and his colleagues to evaluate programs and services, determining best practices, and making plans for the immediate and long-term future.

“CHOC is certainly honored to be recognized once again by U.S. News. But our dedication to serving the best interests of the children and families in our community is what truly drives us to pursue excellence in everything we do. Our scores, especially in the areas of patient-and-family-centered care, commitment to best practices, infection prevention, breadth and scope of specialists and services, and health information technology, for example, reflect our culture of providing the very best care to our patients,” explains Dr. Cappon. To hear more about CHOC’s commitment to patient safety and quality care—and what parents need to know— listen to this podcast.

CHOC’s culture of excellence has it earned it numerous accolades, including being named, multiple times, a Leapfrog Top Hospital. Additional recent honors include the gold-level CAPE Award from the California Council of Excellence; Magnet designation for nursing; gold-level Beacon Award for Excellence, a distinction earned twice by CHOC’s pediatric intensive care unit team; “Most Wired Hospital”; and The Advisory Board Company’s 2016 Workplace Transformation Award and Workplace of the Year Award. Inspiring the best in her team, CHOC’s President and CEO Kimberly Chavalas Cripe was recently named a winner of the EY Entrepreneur of the Year Award in the “Community Contributions” category.

Sisters Create Diabetes App to Help Patients Communicate with Caregivers

After living with Type I diabetes for most of their childhood, Reece and Olivia Ohmer were already well-versed in educating their family about how they were feeling and caring for themselves. But both girls eventually became bogged down by responding to frequent and complex check-ins and reminders from parents and caregivers, and knew other kids with diabetes likely felt the same. Looking for a better way to communicate with their parents and physicians, the sisters created a diabetes emoticon app, which they are presenting to pediatric specialists, researchers and other health professionals during the Young Innovator Workshop of the Pediatrics 2040 conference hosted by CHOC Children’s.

A mockup of the diabetes emoticon app in development.
A mockup of the diabetes emoticon app in development.

Reece and Olivia created a variety of illustrations to easily answer the most common questions and text messages patients may receive from their parents. For example, if a parent texts “Did you test your blood sugar? Did you have a snack?” the child could quickly and easily reply with emoticons showing a blood glucose meter and a snack.

A student group at the University of Michigan called the “Michigan Hackers” is developing and testing the app, which they hope to make available on iTunes in the first quarter of 2016.

The Ohmer’s Journey

The Ohmer family has had an interesting journey with diabetes. Olivia, the youngest member of the family of four, was diagnosed with the disease when she was three years old. At the time, her older sister Reece would hold her hand during every insulin injection. Three years later, Reece was diagnosed with the same disease.

“When we had our first diagnosis, I didn’t know where our lives were going to go,” says mom Amy. “Instead of taking the situation and looking at it as a burdensome way to live, Olivia and Reece have taken their diagnoses and have done something remarkable.”

The pair has big plans for the future.  In addition to rolling out their diabetes emoticon app, each hopes to pursue a career in the medical field. Reece hopes to go into pediatric medicine to help other kids, while Olivia is interested in becoming a researcher.

“We haven’t found the cure for diabetes yet, so if nobody else can find it, then I want to do it,” she said.

The sisters hope to empower other patients to help one another, Reece added.

“Just because we’re kids doesn’t mean we don’t have good ideas.”

Learn more about other young innovators involved in CHOC’s Pediatrics 2040 Conference.

S.M.A.R.T.I.E.S. Class Helps Kids Manage Type 1 Diabetes

According to the American Diabetes Association (ADA), nearly 30 million children and adults in the United States have diabetes. Diabetes is a metabolic disease in which the body’s inability to produce any or enough insulin causes elevated levels of glucose in the blood.

CHOC Children’s endocrinology and diabetes team provides comprehensive diagnosis and treatment of endocrine disorders, including innovative programs and classes designed to enhance the quality of life for patients. S.M.A.R.T.I.E.S. (Smart Kids/Teens Managing and Regulating their Insulin, Exercise and Sugars), a special class that provides education to newly diagnosed type 1 diabetes patients at CHOC, features interactive activities and learning techniques for different ages. Additionally, the class provides an opportunity for patients to bond with other patients with diabetes. The patient’s siblings and parents are also encouraged to attend.

As part of CHOC’s diabetes new onset education program, which is accredited by the ADA, the class helps support better outcomes and management of this life-changing condition.

The experts at CHOC offer the following holiday eating tips for parents of children with diabetes:

  • Talk to your child’s health care provider. Ask how to best manage extra carbohydrates during the holidays, and what else your child should be tracking.
  • Make ready for the feast. When visiting over the holidays, try to learn about the menu beforehand. Bring supplies such as measuring cups if necessary. Practice measuring things at home so you can become a good estimator.  Similarly, plan ahead when going out to eat. Many restaurants post their menus on their websites. Check the nutrition information beforehand.
  • Slim it down. If you are doing the cooking, use skim versus whole milk, or artificial sweetener instead of sugar in your favorite recipes. The rest of your family may not taste the difference and will likely appreciate the fewer calories and fewer carbs.
  • Tell other parents. If your child is going to a party, mention to the host parents that your child has diabetes. This will help them understand why your child is using a meter or insulin pen. Provide phone numbers in case of an emergency.
  • Focus on the festivities. Holidays are often centered around food with family and friends. This can be stressful for parents who are attempting to manage a child’s blood sugar. Where possible, try to implement traditions that focus less on food.

S.M.A.R.T.I.E.S. is for new onset CHOC patients and their families.  Families are scheduled into one of two monthly classes as a follow up to the hospital education.  For more information, including other resources available, please call 714-509-8634.

Charlie Kimball talks about racing and overcoming the challenge of having diabetes

Charlie Kimball is a winning racecar driver who isn’t letting type I diabetes put the brakes on his success.

He recently stopped by CHOC Radio to talk about his career and diagnosis, and how he balances the two. Being active and making good nutrition choices helps Charlie excel professionally and manage his condition, he says.

Charlie began racing at age 9, stopping briefly after his 2007 diagnosis. The following year, Charlie resumed his career and went on to be the first licensed driver with diabetes to win a race in the Verizon IndyCar Series.

Listen in to hear more about Charlie’s inspiring story.

Simple Steps to Help Prevent Type 2 Diabetes

It’s American Diabetes Month, a perfect opportunity to educate your family about this increasingly common disease. Unlike type 1 diabetes, type 2 diabetes – the most common form of diabetes that affects the way the body metabolizes glucose (sugar) – can sometimes be prevented. Obesity and a sedentary lifestyle are factors that put a person at risk for type 2 diabetes.

Be sure to remind your kids of these easy steps that can help reduce their risk for developing type 2 diabetes and other associated health problems:

• Make sure kids eat a healthy diet. Encouraging your kids to eat low-fat, nutrient-rich foods, such as whole-grain cereals and breads, fruits, vegetables, dairy products, and lean proteins, can help prevent excessive weight gain.

• Limit sugary foods and beverages. Consuming lots of sugar-filled foods and beverages, such as sodas, juices, and iced teas, also can lead to excessive weight gain.

• Encourage increased physical activity. Staying active and decreasing the amount of time spent in sedentary activities can also reduce the risk of weight gain and help prevent the onset of type 2 diabetes. Being active can be as simple as walking the dog or mowing the lawn! Try to do something that gets you and your kids moving every day.

If you think your child may be overweight and, therefore, at increased risk of type 2 diabetes, talk to your doctor or a registered dietitian. They can help you determine what your child’s weight goals should be and how to reach them.

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Type 1 Diabetes – Early Detection is Key!

National Diabetes Awareness Month may be over, but the fight against this serious condition in children is not.

When a child is diagnosed with diabetes, life immediately changes for both the child and the family. Diabetes is a condition which affects the body’s ability to utilize blood glucose for energy. The increase in diabetes among children has been an ongoing trend for years, with the risk of developing type 1 diabetes being higher than virtually all other severe chronic diseases of childhood. An alarming new prediction indicates that Type 1 diabetes among children under the age of 15 will increase by 70% by 2020. Type I diabetes (juvenile-onset diabetes), is an immune system disorder that inhibits the body’s ability to produce insulin. The anticipated increase in Type 1 would represent a drastic lifestyle change for millions of children since it requires daily injections of insulin to manage the condition.

Dr. Susan Clark, chair of endocrinology, and her team of clinical experts are passionate in providing the best care for CHOC’s diabetes patients. From carb counting to insulin pump training, the diabetes team focuses delivering family-centered care, through specialized diabetes treatment and education to patients and families. In particular, for Type 1 patients, education is key. According to Dr. Clark, with proper medical care, clinical therapies, diet, hygiene, and exercise, a child with diabetes can live a full and normal life.

Type 1 diabetes often appears suddenly – often resembling the flu in children. According to Dr. Clark, the following are the most common symptoms for type 1 diabetes:

• unusual thirst
• frequent urination
• extreme hunger but loss of weight
• blurred vision
• nausea and vomiting
• abdominal pain
• extreme weakness and fatigue
• irritability and mood changes

The U.S. News and World Report recently recognized CHOC’s diabetes and endocrinology program as one of the top in the country. Regionally recognized for patient care excellence, CHOC’s Endocrinology team provides comprehensive diagnosis and treatment of endocrine disorders and offers several innovative specialty programs and outpatient clinics designed to enhance quality of life for patients.

To schedule an appointment with a CHOC Children’s Endocrinologist, please call (714) 509-7982.

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Getting to Know Diabetes

By CHOC Children’s Clinical Dietitian Specialist, Leah Ballamy MS, RD, CSP

November is National Diabetes Awareness Month! Did you know that every 17 seconds someone is diagnosed with Diabetes? Diabetes is a condition which affects the body’s ability to utilize blood glucose for energy.  There are several types of Diabetes, but the most common are Type 1 and Type 2 Diabetes.

Type 1 Diabetes inhibits the body’s ability to produce insulin, and can be managed with insulin injections, diet and exercise. It’s anticipated that Type 1 Diabetes will increase by 70% by 2020.  Research suggests that unlike Type 1 Diabetes, it may be possible to prevent or delay Type 2 Diabetes, which impairs the body’s utilization of insulin. The prevalence of Type 2 Diabetes is expected to exceed Type 1 Diabetes within 10 years and currently accounts for 90% of Diabetes cases. Studies show that just 30 minutes of moderate physical activity daily and a 5-10% reduction in body weight can reduce the risk of Type 2 Diabetes by 58%.

Know the signs and symptoms of Diabetes. Early diagnosis saves lives!
-Excessive thirst
-Frequent and excessive urination
-Fatigue
-Dehydration
-Weight loss
-Nausea/vomiting

Treatment and prevention includes:
-Avoid concentrated sweets and sugary beverages such a regular soda, juice and sport drinks.
-Consume an average of 45-60g carbohydrates per meal and 5-15g carbohydrates per snacks (50-60% total calories).
– Eat every 3-4 hours. Avoid skipping meals and eating late at night.
-Eat more fiber from whole grains, fruits, vegetables and legumes.
-Decrease saturated fat (7-10% total calories) and total fat (25-30% total calories). Choose lean meats, low-fat dairy products and low-fat snack foods.
-Exercise 60 minutes daily
-Moderately reduce usual food intake by 250-500 calories, which should promote weight management/slow weight loss
-Check blood glucose and take medication as instructed

Where to find more information about Diabetes:

www.padrefoundation.org  (Pediatric Adolescent Diabetes Research Education)
www.jdrf.org (Juvenile Diabetes Research Foundation)
www.Diabetes.org (American D iabetes Association)
www.childrenwithdiabetes.com  (family  support network)

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