Dr. Floris Levy-Khademi, Director of the Pediatric Day Hospital recently reported on the hospital’s developing program for the research and treatment of Juvenile Diabetes. She says that the incidence of Type 1 Diabetes, wherein patients require regular injections of insulin and very close monitoring of their dietary intake, is on the rise in the Western world and Israel is no exception.
Shaare Zedek has become increasingly recognized as a center of excellence for the treatment of children with the condition. At present, the hospital is overseeing the treatment of about 120 children with the disease with an average of one to two new patients each month. The large majority of those being treated were diagnosed over the past two years.
Dr. Levy-Khademi has presented her vision for juvenile diabetes care which places the child and his or her family within a circle of multi-disciplinary services to ensure that the child is receiving comprehensive care. “The goal is to ensure that every aspect of the child’s needs is being looked out for by the hospital,” she says. “This obviously includes medical care but extends to issues like dietary support, close consultations with our social worker and integrating the patient’s need for ongoing hospital visits within their educational frameworks.”
According to research presented by Dr. Levy-Khademi, Type 1 diabetes has both genetic and environmental causes as well as indicators that higher birth weights are a key factor in dictating whether a child may end up contracting the disease.
Shaare Zedek’s work has also concentrated heavily on the importance of technology in assisting pediatric diabetes patients. In recent years, significant progress has been made with the use of insulin pumps and glycemic monitors. The eventual goal is to create a perfected hybrid of the two devices so that patients can receive carefully calibrated doses of insulin to even further better the quality of life for these children for whom the disease can be highly debilitating.
Shaare Zedek’s pediatric teams are also involved in several ongoing diabetes research studies particularly oriented to the unique demographic make-up of the hospital’s patients. One study worked to identify how Jewish and Muslim families with children with diabetes differ in their dietary habits. The study found that the Jewish families were generally more responsive to the guidelines recommended by the dieticians; findings which helped the dieticians understand that they needed to focus more heavily on communicating with the Arab families and providing them with specific recommendations for what is right and wrong for their children to be eating. A separate study analyzed the safety of fasting on ritual fast days, research which is equally relevant for both Jews and Muslims. The study concluded that with careful medical guidance fasting is possible under the correct circumstances and the proper planning.
The Department has developed specific training programs, using interactive games that children can best relate to, to educate the patients on a level they can understand. Children are carefully taught how to monitor their glucose levels, administer injections (where relevant in cooperation with adults), and to identify the warning signs that their well being could be in jeopardy.
“The goal of our provision of care for these patients is to address both their direct physical and medical needs but also to help them confront the overall lifestyle challenges that come when confronting a disease like diabetes,” Dr. Levy-Khademi says. “This is accomplished through this holistic approach which we feel empowers them with the tools and confidence to manage their conditions in the best way possible”.