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March 6, 2006

Research: Cure, Research: Monitoring

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Question from Wayland, Massachusetts, USA:

With all the talk of the continuos glucose sensors being the wave of the future in diabetes care (MiniMed’s actually in use in designated cities), when do you realistically see these being available to children under the age of 18? My daughter is eight years old, uses a MiniMed 515, is very responsible and has excellent A1cs. Also, under the current school guidelines, our daughter is not able to administer insulin in the classroom without a nurses supervision. It hasn’t been a huge issue because she tests at snack, lunch, and pre-bus and, if necessary, will give herself a correction dose in the nurse’s office at those times.

While the continuous glucose sensor taking readings every five minutes is fantastic, how does a child get around making corrections if the sugars are too high under the current laws without the teacher sending her to the nurse several times a day? Last question, any ideas on how long it will take before they close the loop and ultimately create a true “artificial pancreas?”

Answer:

From: DTeam Staff

Exactly when such advances are available for large numbers of people and children is somewhat speculative. None of us can answer such queries with any definitive answer. Your school problems, however, can be solved, but you may need to know your rights and likely need to insist that the school create a specific education plan vis-a-vis diabetes for your child. This is mandated by federal, as well as state law, and Massachusetts is one of the states with one of the best state laws to help. Please enroll the assistance of your diabetes team to give you guidance about what can and cannot be done in the school, how to go about creating such a diabetes specific school plan, how to ensure that safety and common sense prevail, etc. If you need more guidance, see the ADA’s web page on School Discrimination. The JDRF web site can also provide you with information on Diabetes in School. The chapter by Linda Siminerio in my textbook written Pediatric and Adolescent Diabetes is also a good resource about such school issues and rights.

SB

[Editor’s comment: If you are asking how in-school corrections would work with a continuous sensor in use, keep in mind that corrections are usually not done with each blood sugar reading. Most people are instructed by their diabetes team to administer corrections related to the duration of the insulin. In other words, if your daughter’s insulin lasts three hours, you would do corrections every two or three hours. So, if your school were to require it, your daughter could still go to the nurse to do her corrections. If your daughter is attending a public school and you want her to be able to do corrections in the classroom, you probably need to have a Section 504 plan.

I believe several companies, including Medtronic MiniMed are working on an artificial pancreas.

BH]