Grant: Operating Grant: Analyses of Existing Cohorts & Databases - IHDCYH

Type 1 diabetes mellitus (T1DM) requires life long insulin therapy to treat high blood sugars. Without insulin, children die. T1DM is one of the most common chronic diseases in children. Unfortunately, Canada has one of the highest rates. Long-term diabetes can lead to several health problems including poor blood flow to the feet, kidneys and heart. This can result in health problems including the need to amputate feet, kidney failure needing dialysis or even early death. Several research studies have shown that keeping the blood sugars as close to the non-diabetes range reduces the risk of these health problems. However, almost normal blood sugars can increase the chance of going to the hospital because of a very low blood sugar. One way or keeping blood sugars in 'tight control', is to use an insulin pump or a device that provides small quantities of insulin around the clock and extra when one eats. These devices are expensive and so all the provinces of Canada help families with children with T1DM to be able to afford the pump ($7000) and annual supplies ($4000). It would appear that for families of lower income and education (lower socioeconomic status (SES)) their children often do less well using the pump compared to families of higher SES in Ontario. This project is about looking how well children in Quebec do with their pumps because Quebec covers all costs for the pump unlike Ontario where only a portion of the supplies are paid for. We believe that full coverage for blood sugar testing strips and other supplies may allow all families in Quebec to do well and avoid going to hospital. We will also be looking at how children with T1DM on the pump in Quebec and Manitoba do overall with regards to hospital visits compared to children in those provinces not using the pump. The reason for this study is to try to ensure that all children with T1DM be able to stay as healthy as possible and to optimize how we provide tools and supports for care.