World Diabetes Day: SickKids STAR Clinic helps provide one-on-one education
By Kayla Redstone, Intern, Communications & Public Affairs
Bradley Stoner was only 19 months old when he was rushed to The Hospital for Sick Children (SickKids) with diabetic ketoacidosis. The condition, which results in acidic blood, is caused when the body’s natural insulin can no longer manage blood sugar levels. He was diagnosed with Type 1 diabetes, which occurs when the immune system attacks the insulin producing cells in the pancreas and little or no insulin is produced.
Bradley’s mom, Stephanie Stoner, had never known anyone with diabetes before her son fell ill. She took him to a clinic after she noticed he was frequently urinating through his diaper, rapidly losing weight and appeared more tired than usual. The doctor urged Stoner to take her son to a local hospital, which quickly referred him to SickKids.
Nine years later, Bradley and his family have a new list of things to keep in mind each day—making sure his blood sugars are within his target range, monitoring his diet and making sure he gets enough exercise. The SickKids Self-Management Teaching and Review (STAR) Clinic now helps the family make sure Bradley's care plan matches his changing needs.
Unlike regular diabetes appointments, visits at the STAR Clinic are led by a registered nurse or dietitian rather than a doctor, allowing more time for patients to learn how to manage their condition on a day to day basis. The SickKids diabetes team started the clinic in 2012 to allow allied health-care professionals to provide yearly diabetes management follow-ups in addition to regular doctors’ visits. The clinic focuses specifically on education and promoting self-management.
“The STAR Clinic is an innovative way of delivering health care that is based on our clinical experience and research. We can establish more of a rapport with our patients during these appointments to empower them through education and review,” says Esther Assor, registered dietitian in the STAR Clinic.
The 45-minute appointments go beyond a routine check-up by allowing families to consult their nurse or dietitian about specific issues alongside their regular diabetes care. This means that the STAR team can conduct a normal check-up—monitoring sugar levels and asking about insulin use—but also make time to talk more about the patient’s personal experiences and challenges. For example how patients know when their sugar is low or how the family can adjust their meals to work around their child’s needs. They take extra time to identify any learning gaps and provide targeted one-on-one education as needed.
The nurses and dietitians also support the patient as they transition through different developmental stages to become more proficient in managing their own diabetes care. The detailed appointments allow staff to suggest changes to the child's diabetes management program, which is especially important when they are faced with new milestones such as puberty or enrollment in seasonal physical activities.
"Bradley sees his doctor on a regular basis, bur STAR clinic allows our family to receive more specialized one-on-one care where we can have our more specific questions answered" says Stoner.
According to a family satisfaction survey conducted by the diabetes clinic, Stoner isn’t alone. Families strongly agreed they learned more about the child's diabetes management at STAR Clinic appointments than regular clinic visits. Families also strongly agreed the STAR Clinic visits addressed important diabetes topics and answered all of their diabetes-related questions. The results are evident in patient outcomes.
“We try to secure our patient’s health through education and support. It is important to build a relationship,” says Assor.