1. Patient Cases Patient Cases Introduction

2. Jesse 7yo Caucasian boy Diagnosed with Type 1 age 3. 4 year 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 10 th 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.