Intensive vs. conventional insulin management initiated at diagnosis in children with diabetes: should payer source influence the choice of therapy?

Intensive insulin management (IIM) in type 1 diabetes facilitates improved glycemic control and a reduction in long-term diabetes complications. We hypothesized that IIM can be started at diagnosis without deleterious effects on hemoglobin A1c (A1c), body mass index (BMI), and severe hypoglycemia regardless of payer source. Type 1 diabetes patients aged 0-18 yrs, in an academic endocrinology practice were identified for a retrospective chart review.

Cystic fibrosis related diabetes in an extremely young patient.

Diabetes in patients with cystic fibrosis (CF) is common but typically does not occur before the age of 10 years. We describe a male with cystic fibrosis who developed diabetes, consistent with cystic fibrosis related diabetes, at the age of 2 years and treated successfully with insulin.

Reimbursement for pediatric diabetes intensive case management: a model for chronic diseases?

Objective: Current reimbursement policies serve as potent disincentives for physicians who provide evaluation and management services exclusively. Such policies threaten nationwide availability of care for personnel-intensive services such as pediatric diabetes. This report describes an approach to improving reimbursement for highly specialized, comprehensive pediatric diabetes management through prospective contracting for services.