pediatric housecalls Robert R. Jarrett M.D. M.B.A. FAAP

Over 20 years ago, while I was in the service, a new method of testing diabetics for blood glucose control was “discovered” and I instantly seemed to know in my gut that it would revolutionize the care for the whole clinic full of patients I was managing – not to mention those kids at camp UTADA diabetic camp I saw every fall. (more…)

I’d like to talk today about a “new med” for “juvenile diabetes.”

By ‘childhood diabetes’ I mean the ‘type 1’ diabetes that used to be most predominant in childhood as opposed to the ‘type 2’ which used to be most predominant in adulthood. Two different diseases which, confusingly, have the same name.
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It seems like we just “think” we’ve got something understood when a new discovery erases part of the “wording” and adds a new paragraph. Diabetes was once just “adult onset” and “juvenile onset.” Adult onset had to do with obesity in some way and juvenile onset the pancreas and too often cachexia (inordinately underweight).

Then, some adults were discovered to develop the “juvenile type” and with the sedentary lives of couch potato children they began developing the “adult type” too. So, the names were changed to “type 1” and “type 2” respectively.

Little progress was made in treatment until “Hemoglobin A1C” was discovered as a measurement of control, long-acting insulin was developed and diet was better understood. A whole new paradigm ensued, and a new plateau became not comfortable but tolerable.

Then, computer, space, miniaturization and remote sensing advances exploded progress again, and frankly it hasn’t stopped yet.