Patient Cases Introduction

1. Patient CasesIntroduction

2. Jesse 7yo Caucasian boy • Diagnosed with Type 1 age 3. • 4year old brother, Tyler. • Family completed Diabetes Center’s Education & Management classes • On a pump and he pokes his fingers, with guidance from his parents • Mother, Megan, is a single parent. • Lives at home since divorce • Father was a drug addict and is not in contact

3. Kenny 15 yo Caucasian boy • Newly diagnosed with Type 1 in hospital about to be discharged • Kenny and his parents interpreted classic symptoms of diabetes as just “a thing” related to stress from school and sports. • Plays high school basketball • Harder and longer workouts explained his excessive fatigue, fluid intake and urination • He appeared pale and gaunt with symptoms worsening

4. April 17 yo Caucasian • Type 1 diabetes for 6 years • Senior in high school looking forward to the Senior Prom and applying to colleges out of state • She thinks she’s doing fine • Lost weight since her last appointment • Presents as distant, grouchy and responds to questions with an eye roll • At diagnosis attended diabetes education classes with her family which included her 14 yo brother • The family is upper middle class

5. Maria 15 yo Hispanic • Type 2 diabetes diagnosed in May of 2008 • Complains of blurry vision, nausea and diarrhea • Thinks symptoms might be due to one of her meds • So she periodically skipped some of her meds to determine which one is causing the problem • She is in 10th grade and has a boyfriend • Lives with her mother and 3 younger brothers • Entire family is overweight

6. Ellen 13 yo African American • Type 1 for 10 years • On insulin pump for the last 6 months • Since pump therapy A1c has gone from 7.8 to 9.6% • Weight has decreased 2 lbs. • Says she knows how to use the pump • Frequently misses her lunch bolus • She says it’s “hard to remember to bolus.” At her clinic visit a week ago Ellen promised to “do better.” • Mother presents as extremely frustrated and distraught.