What is adult diabetes transition, Alex?
Madison, Wisconsin - "This is very important to do before you drive," said UW Health endocrinology nurse clinician Amy Pitts, a note card in her hand and the answer she just read projected on a large screen behind her.
As she finished the sentence, a teenager, one of six in the UW Health West Clinic conference room who have been treated for diabetes at the Pediatric Diabetes Clinic, slapped a buzzer to indicate he knew the question corresponding to the answer Pitts provided.
"What is check your blood sugar?" he said.
Channeling her inner Alex Trebek, Pitts said, "That is correct!"
With that the Gods and Goddesses – the name the teens chose for their team – surged ahead of The Overlords, the opposing team consisting of their parents, in a game based on the popular television quiz show "Jeopardy!"
This version had a very specific purpose – teaching kids with diabetes how to take responsibility for their care so they can thrive as adults.
"We're focusing on patient knowledge," said Tracy Bekx, MD, a UW Health pediatric endocrinologist who helped organize the day's activities. "Part of the success in transition is how much the adolescents understand about their own disease."
If the results of Jeopardy! – the Gods and Goddesses maintained a 1,500- to 2,000-point lead for a majority of the contest before a few generous scoring decisions by Pitts narrowed the final margin – are any indication, the teens have a solid knowledge foundation upon which to build. And that's a good thing, because transition from the pediatric diabetes world to the adult diabetes world is complex.
Start with the daily attention diabetes requires. People with diabetes have to check their blood sugars four to six times per day. They have to construct a diet with the right blend of proteins, carbohydrates and fats, with an emphasis on fruits and vegetables. They have to remember to have a fast-acting sugar source readily available at all hours, in case they need to address a low. They need to calculate their proper insulin doses.
Most of the teens have been doing these things for years, but with the assistance (or at the insistence) of their parents. Being an adult with diabetes means taking care of all of the little details that contribute to daily health, and not relying on your parents to remind you.
"The day-in, day-out stays the same," said Dr. Bekx. "But it's who is in charge that changes."
To that end, Dr. Bekx, Pitts and members of both the pediatric and adult diabetes care teams at UW Health catered Jeopardy! in a way that addressed issues that will arise when the teens move out of their parents' houses.
"The answer is, ‘Measuring cups, measuring spoons and a food scale,'" Pitts said, and pointed to a teen who beat her mother to the buzzer by a fraction of a second.
"What are tools that help with carb counting?" the teen answered, and offered a subdued fist pump when Pitts awarded her team the points.
Jeopardy! also addressed topics such as:
- Allowing doctors to talk to parents about your care when you turn 18: Patients need to sign a release of information form to make that happen
- How often patients should be seen at the adult diabetes clinic: The standard of care is every three months, and more, if needed
- The impact alcohol has on diabetics: Alcohol increases the risk of low blood sugar levels and may negate the effects of glucagon, a hormone that increases the concentration of glucose in the bloodstream.
- Using iPhone or Android apps to monitor glucose
The game was a fun, interactive way to get the kids thinking about the many facets of diabetes care, and was the centerpiece of a day of education that also included information about the specific health risks diabetes patients face, navigating the maze of health insurance, and keeping up-to-date with medications.
"You start having these conversations early rather than waiting until they're 18," Dr. Bekx said. "By the time these young adults with diabetes are leaving the home, the diabetes team and parents, hope to have prepared them to be successful in managing their diabetes and to be advocates for their own health."
Date Published: 08/10/2015