Technology-Enabled Pediatric Diabetes Management
As a translational researcher in pediatric diabetes, Dr. Mark Clements works to bring basic science discoveries to children and teens in ways that improve how they manage diabetes. By decoding Children’s Mercy Hospital’s impressive 28 years of retrospective data into real-time learning, creating innovative data-sharing technologies, and by encouraging his patients to participate in enhanced communication strategies and key clinical trials, Clements is giving diabetic children the freedom to be kids again.
Diabetes management is one of the most burdensome care regimens of all chronic diseases. Patients must follow a taxing agenda of self-care to maintain good blood sugar control. Each day, patients test blood glucose multiple times, self-administer insulin doses, count all ingested carbohydrates, and consume snacks or water at particular times to regulate blood sugar levels. “You come to the conclusion that patients with diabetes have to do something to care for the disease approximately every waking hour of a day, which is just an incredible burden for a chronic disease,” attests Clements.
To combat this burden, Clements is working to develop technology that promotes communication between patients and their diabetes care team. Such technology enables caregivers to provide patients with valuable treatment advice the moment it is needed. To create a data mobility system specifically for diabetes, Clements turned to Heart to Heart, a Kansas City-based company specializing in the transfer of real-time health data from patients to doctors. This collaboration led to developing tools used in a pilot study evaluating how diabetic patients respond to real-time data listening technologies.
Clements’s proposed system allows patients to share data from their mobile devices to the Cloud and then to the Diabetes Center for evaluation by a diabetes care team. The system would allow doctors to use real-time data listening to detect patterns that might prompt change in a patient’s treatment. “As a result of this type of technology, we can theoretically be much more available and accessible to patients,” says Clements. “It can be a driver for communication between clinic visits and a driver for change in diabetes care between clinic visits.”
In addition to technology platform development, Clements conducts clinical trials in type I diabetes patients and individuals at risk for type I diabetes. Clements’s clinical trial work occurs currently through the TrialNet research program, an NIH-sponsored clinical trials network that identifies family members of patients with type I diabetes who are at risk of developing the disease themselves. TrialNet then offers these individuals the opportunity to participate in clinical trials of new medicines designed to prevent the onset of type I diabetes. Children’s Mercy is proud to be one of only eighteen clinical centers in the nation leading this effort.
Clements’s also performs clinical trials focused on developing and testing behavioral interventions to improve the way patients manage diabetes. In partnership with his colleagues Kathy Goggin and Susana Patton at the University of Kansas Medical Center, Clements conducted clinical studies on mealtime insulin bolusing, a practice of self-administering insulin at mealtimes, in teens with varying levels of engagement in their treatment. These studies revealed that the best method of minimizing risk of future complication due to diabetes is high adherence to treatment regimen. Clements is also partnering with colleagues Sara Gardner and Tim Apodaca on a clinical trial of motivational interviewing for teens with type I diabetes with the goal of finding the best ways of encouraging teens to engage with their treatment regimens.
By developing a data mobility system that allows patients to receive treatment advice at any time, testing methods of diabetes prevention, and searching for better ways to encourage teenage participation in their treatment, Clements is greatly improving how diabetic patients interact with their disease. His work at Children’s Mercy Hospital continues to make a diabetes diagnosis more manageable for Kansas City children, teens, and families.