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Morristown Medical Center Team Finds Listening to Teens May Help Them Better Control Type 1 Diabetes

April 18, 2019

Study Recently Published in American Psychological Association Journal

Morristown, NJ – A new study by a team at the BD Diabetes Center at Atlantic Health System’s Goryeb Children’s Hospital headed by Harold Starkman, MD, director of pediatric endocrinology, found that teens with poorly controlled Type 1 diabetes can experience anger, frustration and anxiety, fraying the relationships they have with their parents and health care providers and impacting their treatment and self-management. A better approach, the team found, was for parents and providers to reduce stress and promote success by simply listening to patients as they described their efforts and struggles.

The study was published in the March 2019 issue of the American Psychological Association’s Family, Systems, & Health® journal.

In order to control blood sugar levels, people with Type 1 diabetes must test their blood frequently and take insulin, which requires diligent monitoring. For teens, this can be especially difficult while managing school and extracurricular activities.

Dr. Starkman and his team, which included Nicole Pilek, MSW, LCSW, the pediatric endocrine social worker at Goryeb Children’s Hospital, and Gloria Lopez-Henriquez, a counselor at CONCERN Behavioral and Management Solutions, recruited nine adolescents between the ages of 13 and 18 who had been diagnosed with Type 1 diabetes more than a year earlier and had average hemoglobin A1C levels, a test that measures blood sugar levels over a period of several months, of more than 9.0% -- well above normal.

The seven girls and two boys, all patients at Goryeb Children’s Hospital, were each interviewed with their parents. Ten healthcare providers were interviewed in separate sessions.

The interviews revealed significant conflict, potentially impacting treatment. The teens often expressed not feeling understood even as they tried to control their disease, parents’ fears were expressed as anger at their children, and health care providers distanced themselves by focusing on blood sugar levels instead of seeing patients as busy teens who were doing the best they could.

By acknowledging patients’ efforts and being sensitive to the feelings of all involved, say the researchers, the chances of patients being better able to control their blood sugar increase.

“The idea is to transition from a focus on numbers to an understanding that the relationship between patients, parents, and health care provider is critically important and can motivate patients to be more engaged and improve their health,” said Dr. Starkman. “This kind of listening and understanding can prevent adolescents from dropping out of medical care.”

Recent research reveals that up to 30% of older adolescents whose diabetes is not well controlled don’t transition when pediatric care is no longer appropriate and may return for medical care only after developing complications.

“Dr. Starkman has been trying for a number of years to better understand and address some of the underlying issues involved with adolescents whose Type 1 diabetes is difficult to control,” said Walter Rosenfeld, MD, Chair of Pediatrics, Goryeb Children’s Hospital and Atlantic Health System. “This study shows that effective communication by patients’ parents and the entire health care team should help inform approaches to care for all patients with diabetes.”

The American Diabetes Association recommends that children under age 19 who have Type 1 diabetes aim to keep their A1C levels below 7.5%. This is because prolonged periods of high blood sugar can result in serious complications such as cardiovascular, eye, and kidney disease.

The BD Diabetes Center at Goryeb Children’s Hospital is certified by the American Diabetes Association and is nationally recognized for the development of innovative educational and support programs for both families and health care professionals.

About Atlantic Health System

Atlantic Health System is at the forefront of medicine, setting standards for quality health care in New Jersey, Pennsylvania and the New York metropolitan area. Powered by a workforce of more than 16,800 team members and 4,800 affiliated physicians dedicated to building healthier communities, Atlantic Health System serves more than half of the state of New Jersey including 11 counties and 4.9 million people. The system offers more than 400 sites of care, including six hospitals in New Jersey: Morristown Medical Center and Goryeb Children’s Hospital in Morristown, Overlook Medical Center in Summit, Newton Medical Center in Newton, Chilton Medical Center in Pompton Plains, and Hackettstown Medical Center in Hackettstown.

In addition to the employed workforce, Atlantic Alliance, a Clinically Integrated Network represents more than 2,500 health care providers throughout northern and central New Jersey. This network includes 1,000 physicians and providers comprising one of the largest multi-specialty practices in New Jersey - Atlantic Medical Group, as well as members of the Atlantic Accountable Care Organization and Optimus Healthcare Partners which work to enhance patient care delivery.

Atlantic Health System provides care for the full continuum of health care needs including 12 urgent care centers, Atlantic Rehabilitation and Atlantic Home Care and Hospice. Facilitating the connection between these services on both land and air is the transportation fleet of Atlantic Mobile Health.

Atlantic Health System leads the Healthcare Transformation Consortium, a partnership of seven regional hospitals and health systems dedicated to improving access and affordability and is a founding member of the PIER Consortium – Partners in Innovation, Education, and Research – a streamlined clinical trial system that will expand access to groundbreaking research across seven health systems in New Jersey.

Atlantic Health System has a medical school affiliation with Thomas Jefferson University and is home to the regional campus of the Sidney Kimmel Medical College at Morristown and Overlook Medical Centers and is the official health care partner of the New York Jets.