Improving Diabetes Management for School Health Workers using a Live, Virtual Training Course

Background: Type 1 diabetes is one of the most common chronic diseases in childhood. Optimal school nurse and staff education is critical to creating a safe learning environment and influencing long term outcomes of students with type 1 diabetes. The purpose of this project was to develop a virtual continuing education diabetes management course for school health workers to improve their knowledge of diabetes management and evaluate the effectiveness of the learning platform. Methods: A total of 199 participants completed the live, virtual continuing education course. Participants completed a pre and post-test to assess improvements in the key learning objectives of the course content which included diabetes pathophysiology and delivery of appropriate diabetes care in the school setting. Results: There was an improvement in knowledge in all questions from the baseline pre-test scores to the post-test scores. 99% of participants responded that they would use what they learned from the course in their professional practice, and 97% reported that they were able to list at least one concept learned from the conference. 60% reported that the diabetes management course was exceptionally better when compared to other virtual events, and the overall rating of the course was 4.82 on a 5-point Likert scale. Conclusions: The live virtual diabetes management course for school healthcare workers was successful, with an improvement in participants’ knowledge of key diabetic management skills. The benefit of the virtual platform was the ability to expand beyond our local region to a larger audience outside of the state and could be adapted for other institutions to utilize. Appropriate and accessible training for school health workers is critical to ensuring safe practices for children with diabetes to attend and thrive at school

Differences in Hyperandrogenism Related to Early Detection of Non-Classical Congenital Adrenal Hyperplasia on Second Newborn Screen

Screening for congenital adrenal hyperplasia (CAH) remains heterogenous across geographies—we sought to determine the proportion of non-classical CAH (NCAH) detection by one vs. two newborn screens (NBS) in two U.S. regions. Data were collected at tertiary centers in Houston (HOU) and Los Angeles (LA) on 35 patients with NCAH, comparing patients identified via the NBS vs. during childhood, 17-hydroxyprogesterone (17-OHP) levels, genotype, and phenotype. The NBS filter-paper 17-OHP levels and daily cutoffs were recorded on initial and second screens. In all, 53% of patients with NCAH in the HOU cohort were identified as infants via the second NBS. Patients identified clinically later in childhood presented at a similar age (HOU: n = 9, 5.5 ± 3.1 years; LA: n = 18, 7.9 ± 4 years) with premature pubarche in almost all. Patients in LA had more virilized phenotypes involving clitoromegaly and precocious puberty and were older at treatment onset compared with those identified in HOU by the second NBS (HOU: 3.2 ± 3.9 years; LA: 7.9 ± 4.0 years, p = 0.02). We conclude that the early detection of NCAH could prevent hyperandrogenism and its adverse consequences, with half of the cases in HOU detected via a second NBS. Further studies of genotyping and costs are merited