Diabetes Care at Diabetes Camps
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WRITTEN CAMP MANAGEMENT PLAN
A written plan that includes camp policies and medical management procedures must be available at camp. It should be written or reviewed by the camp medical director in collaboration with others, such as the camp program director, members of the camp oversight and/or policy committees, local pediatric endocrinologists and diabetes educators, etc. It must adhere to the ADA’s standards of medical care and the American Camping Association’s accreditation standards. All medical staff should review this management plan before camp.
The written medical management plan should include information about:
* General diabetes management
* Insulin injections/pump therapy
* Blood glucose monitoring and ketone testing
* Nutrition, timing, and content of meals and snacks
* Routine and special activities
* Hypoglycemia and treatment
* Hyperglycemia/ketosis and treatment
* Medical forms
* Assessment and treatment of intercurrent illness
* Pharmacy compendium
* Universal precautions and policies for needle sticks and handling of infectious wastes
* Psychological issues at camp
* Quality control of medical equipment according to OSHA and CLIA standards
* Incident/accident reporting
* When to notify parents/guardians, primary care physician, and diabetes care provider
* Policies for camp closure and returning home
In addition, camp policies should cover emergency procedures (e.g., medical and natural disasters), out-of-camp excursions, and the prevention of physical, sexual, and psychological abuse. A risk management plan should also be developed and understood by all camp staff. The ADA’s Camp Implementation Guide Modules includes a variety of resources including sample policies, job descriptions, and medical forms.
DIABETES EDUCATION AND PSYCHOLOGICAL ISSUES AT CAMP
The camp setting is an ideal place for teaching diabetes self-management skills. Education programs should be developmentally appropriate. Examples of educational topics suitable for the camp setting include:
* Blood glucose monitoring
* Recognition and management of hypo-/hyperglycemia and ketosis
* Insulin injection techniques
* Carbohydrate counting
* Insulin dosage adjustment based on nutrition and activity schedules
* Pump issues
* The importance of diabetes control
* Healthy lifestyles issues, including integration of healthy eating, physical activity, and relaxation
* Problem-solving skills for caring for diabetes at home versus camp
* Life skills for independent living
* Stress management and coping skills
* Sexual health and preconception issues
* Diabetes complications
* New therapies including technologies
Medical personnel with the aid of on-site psychologists/social workers, if available, should aim at improving the psychological well-being of campers. These staff members should be willing to address specific and general psychosocial issues and be able to offer suggestions for subsequent follow-up if indicated. Individualized attention may be needed for campers with type 2 versus type 1 diabetes.
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