Advancing Pediatric Care for Children with Type 1 Diabetes

Caring for children with Type 1 Diabetes (T1D) presents unique challenges, as it requires addressing a broad spectrum of developmental stages. Achieving successful outcomes relies on a psychosocial approach, where clinical teams must provide education and support to both the child and their family. This enables them to manage treatment effectively around the clock and through various life events. Traditionally, models of care for pediatric T1D have involved routine outpatient clinic visits every 3–4 months, typically with a multidisciplinary team.

Although the International Society for Pediatric and Adolescent Diabetes (ISPAD) provides evidence-based care guidelines, the extent to which these are being implemented in practice remains uncertain. A recent literature review found that these models are generally associated with positive health and psychosocial outcomes, greater patient engagement, and cost-effectiveness.

The studies reviewed highlighted the importance of multidisciplinary teamwork, education, and capacity building in supporting self-care. They also emphasized shared decision-making between healthcare providers and patients, as well as the role of outreach support enabled by technology. Improvements in health outcomes, such as better glycemic control, were particularly evident in models that incorporated these elements. Additionally, these studies demonstrated improvements in quality of life, increased satisfaction for patients and caregivers, and enhanced communication. Shared decision-making and care were linked to significant improvements in quality of life, support, and motivation. While outreach models showed no negative outcomes, they faced challenges related to technological and cost barriers limiting access.

The findings suggest that advancing pediatric care for children with T1D through innovative models holds promise, but to fully realize their potential, the healthcare community must focus on understanding and addressing the barriers to implementation and sustainability. With more robust evidence, these models can be refined and expanded, offering improved care and better outcomes for children living with T1D.

Carrigan A, Meulenbroeks I, Sarkies M. et al. Benefits, implementation, and sustainability of innovative pediatric models of care for children with type 1 diabetes: a systematic review. BMC Pediatr. 2024; 502. https://doi.org/10.1186/s12887-024-04945-2