Problem Identification – Juvenile Diabetes

Problem Identification – Juvenile Diabetes

The problem of concern identified in pediatric patients is juvenile diabetes. Juvenile diabetes, or Type 1 diabetes, is a type of diabetes that develops as a result of the immune-mediated depletion of insulin-producing pancreatic β-cells, leading to the inability of the body to produce sufficient amounts of insulin (Ginnard et al., 2021). The loss of the ability of the body to secrete insulin can occur as the destruction of the starts or gradually throughout the patient’s life. This creates the need for the patient to be dependent on life-long insulin replacement therapy to effectively manage their blood glucose levels. Juvenile diabetes exhibits a lot of heterogeneity in metabolic, genetic, and immunogenetic characterization, hence creating a need for personalized approaches to individual patient care planning (Speight & Pouwer, 2023).

Consistently, there are various aspects of juvenile diabetes that create the need to address this health issue among pediatric patients. Firstly, juvenile diabetes is a chronic health condition that is currently seeing a change in its epidemiology. The world is currently experiencing a quick rise in the prevalence of Type 1 diabetes among young children and adolescents. The current incidence rate of juvenile diabetes has been reported to have risen by 3-4% in the last few years (Norris et al., 2020). Secondly, type 1 diabetes, like any other type of diabetes, has significant complications if proper management is not provided and also requires long-term focused and individualized management (Speight & Pouwer, 2023). The diagnosis and long-term costs for caring for type 1 diabetes in children have notable physical challenges, emotional burdens for pediatric patients, and emotional and financial burdens on families, as well as a strain on healthcare systems and available resources (Vitale et al., 2022). Another aspect of concern that warrants immediate efforts to address juvenile diabetes is that it is currently getting diagnosed in adult individuals, creating new challenges to the management of the condition (David et al., 2021). David et al. (2021) further note that the rate of T1DM misdiagnosis as T2DM in adults is high at 40%. Additionally, failure to effectively manage juvenile diabetes is associated with the development of serious complications, such as early-age cardiovascular disease, hearing and sight loss, kidney, and nervous issues, as well as death (Speight & Pouwer, 2023).

Notably, addressing diabetes and managing the associated complications and strain on the individual, their families, and the healthcare system requires the implementation of a quality improvement measure (QIM) within pediatric diabetes care settings. The QIM to be implemented is the T1D Exchange Quality Improvement Collaborative. This QIM for juvenile diabetes is needed due to the lack of high-quality, well-designed interventions for juvenile diabetes and the current gaps between therapeutic innovations and clinical outcomes (Ginnard et al., 2021). There are also notable disparities in patients’ psychosocial needs, knowledge, and access to care, as a notable number of patients are unable to afford insulin (Vitale et al., 2022).

The proposed T1D Exchange Quality Improvement Collaborative is developed based on the success of the Chronic Care Model developed by the Institute for Healthcare Improvement (IHI) (Ginnard et al., 2021). The implementation of the QIM will impact the patients, their parents, care providers, and manufacturers of insulin-related medications and devices. The overall goal of the QIM is to establish a multidisciplinary collaborative approach to managing and preventing juvenile diabetes. An alternative to this QIM will be to implement a local education program on type 1 diabetes to improve awareness of the condition at the community level.

 References

David Leslie, R., Evans-Molina, C., Freund-Brown, J., Buzzetti, R., Dabelea, D., Gillespie, K. M., Goland, R., Jones, A. G., Kacher, M., Phillips, L. S., Rolandsson, O., Wardian, J. L., & Dunne, J. L. (2021). Adult-Onset Type 1 Diabetes: Current Understanding and Challenges. Diabetes Care, 44(11), 2449–2456. https://doi.org/10.2337/DC21-0770

Ginnard, O. Z. B., Todd Alonso, G., Corathers, S. D., Demeterco-Berggren, C., Golden, L. H., Miyazaki, B. T., Nelson, G., Ospelt, E., Ebekozien, O., Lee, J. M., Obrynba, K. S., & DeSalvo, D. J. (2021). Quality Improvement in Diabetes Care: A Review of Initiatives and Outcomes in the T1D Exchange Quality Improvement Collaborative. Clinical Diabetes : A Publication of the American Diabetes Association, 39(3), 256. https://doi.org/10.2337/CD21-0029

Norris, J. M., Johnson, R. K., & Stene, L. C. (2020). Type 1 diabetes—early life origins and changing epidemiology. The Lancet Diabetes & Endocrinology, 8(3), 226–238. https://doi.org/10.1016/S2213-8587(19)30412-7

Speight, J., & Pouwer, F. (2023). Type 1 Diabetes. Cambridge Handbook of Psychology, Health and Medicine: Third Edition, 477–480. https://doi.org/10.29309/tpmj/2017.24.12.614

Vitale, R. J., Wentzell, K., & Laffel, L. M. B. (2022). “Fear That One Day I May Not Be Able to Afford Insulin”: The Emotional Burden of Diabetes Costs During Emerging Adulthood. Diabetes Technology & Therapeutics, 24(12), 915–919. https://doi.org/10.1089/DIA.2022.0170

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Problem Identification – Juvenile Diabetes

Identify a problem or concern from your selected population. Write a 1-3 page description of your problem and support the need to address this in your population with 3 evidence-based articles. Include the title and reference page.

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