Isolation and Education During a Pandemic: Novel Telehealth Approach to Family Education for a Child With New-Onset Type 1 Diabetes and Concomitant COVID-19

A multidisciplinary team, including pediatric endocrinologists, certified diabetes care and education specialists (CDCESs), registered dietitians, psychologists, and social workers is recommended to provide comprehensive medical care and education for children with newly diagnosed type 1 diabetes and their families. Diabetes education can be delivered in an ambulatory setting (home or clinic) or in the hospital inpatient setting (1,2). The standard of care at our pediatric institution, Texas Children’s Hospital (TCH) in Houston, is hospital admission for all children with newly diagnosed type 1 diabetes requiring insulin therapy for safe medication management and education. The child, parent(s), and other caregivers receive in-person comprehensive diabetes education by our multidisciplinary team that occurs over ∼2 days before hospital discharge. However, the COVID-19 pandemic has abruptly affected many aspects of human life, including health care delivery. Concurrent new-onset type 1 diabetes and COVID-19 in a pediatric patient pose a unique challenge for the diabetes care and education team. In this case report, we present a child with new-onset type 1 diabetes and concomitant COVID-19 who was admitted to a Special Isolation Unit (SIU). Rather than our usual in-person pediatric diabetes education, we implemented a novel telehealth approach in an effort to limit the risk of virus transmission to staff and preserve personal protective equipment (PPE), while still achieving the goal of comprehensive new-onset diabetes education. A previously healthy, 10-year-old girl presented to a telehealth visit with her pediatrician with a 2-week history of cough, shortness of breath, abdominal pain, and vomiting in the setting of SARS-CoV-2 (COVID-19) positivity in immediate family members. She was immediately sent to the TCH Emergency Center because of concern that she had COVID-19 that would require a higher level of care. Upon arrival, her review of systems was also positive for polyuria, polydipsia, and unintentional weight loss …