Améliorer les soins de santé et les résultantes d'enfants et d'adolescents atteints de diabète du diagnostic jusqu'à la transition aux soins d'adultes

 

Meranda Nakhla

Institut de recherche du Centre universitaire de santé McGill

 

Domaine : santé de la mère, des enfants et des adolescents

Programme Chercheurs-boursiers cliniciens - Junior 2

Concours 2018-2019

Type 1 diabetes mellitus is one of the most common childhood chronic diseases. Rates are increasing in children, representing a growing burden on the healthcare system. Most children and adolescents with diabetes do not meet the goals of treatment, placing them at risk for diabetes complications including eye, kidney and heart disease. Specific populations are at high risk of complications; including children from low-income families and adolescents when they transition from pediatric to adult diabetes care. We know very little about how to improve care for children from low-income families and do not know how to provide effective transition care services to adolescents with diabetes. 

My research program over the next four years consists of 4 projects addressing these gaps. First, I will determine how well children of low-income families in Quebec and Manitoba do on insulin pump therapy, a device that provides continuous delivery of insulin. Quebec pays for all costs related to insulin pumps, while other provinces only pay a portion. I will determine if this difference in provincial coverage impacts the risk of emergency room visits and hospitalizations in children of low-income families. Second, I will study what happens to adolescents in Quebec when they leave pediatric diabetes care and determine what factors increases their risk of emergency room visits and hospitalizations. Third, I will examine if factors such as self-efficacy in adolescents improves outcomes after transfer. Finally, I will determine if group education visits, a novel alternative to delivering transition care, better prepares adolescents for adult care and reduces complication risk, compared to usual care.

The goal of my research program is to improve outcomes for youth with diabetes by informing how to better deliver healthcare services. My results will be shared with healthcare providers and government decision makers to assist them in improving healthcare delivery.