In this month’s Special Report on Diabetes and in the feature story, “ The Optometrist’s Role as a Diabetes Educator,” you will hear many of the same statistics that you do on the nightly news regarding how many Americans are affected by this disease and how much it’s costing our country. They are disturbing statistics. But, they’re just statistics. They don’t connect you in any meaningful way to the real lives that they represent. Only patients and family members can do that. But, I guarantee that if you invite them to share their stories with you, you’ll learn a lot more about diabetes than we can ever share in this magazine.

You could argue that in no population is effective communication more desperately needed than in a pediatric one. Kids are tough. They suffer from the us-versus-them syndrome. Couple that with a burning desire to be just like all their peers and you have a dangerous combination of fragile self worth and inveterate deceit.

Andrea Martin Mischke, of Maple Grove, Minn., witnessed this firsthand. Andrea is now a registered nurse and Certified Diabetes Educator at the Endocrinology Clinic of Minneapolis. But, as a child, she watched her sister grow up with diabetes and, later, was diagnosed herself. In an emotional poem posted on the American Diabetes Association’s Planet-D (the association’s kids’ network), she shares what it was like for her big sister: “I remember the screaming—blood curdling screams that filled the house—I’d cover my ears and close my eyes as dad held you down and mom did your shot.”

Andrea also recalls watching her sister sneak candy bars and hide her condition from her friends. She continues: “I remember how you’d cry at night wishing it would go away.” Her sister, Becky, has had 24 laser eye surgeries.

The specific hurdles that children with diabetes must overcome depend not only on what type of diabetes they have, but also on where they live and go to school.

Lately, California is topping the list of worst places to be a kid with diabetes. Just this summer, the state’s appeals court ruled that state law prohibits school employees who are not nurses from volunteering to help children with diabetes by administering needed insulin. What does that mean? Some kids in this not-so-golden state will be forced to switch schools, others will get sicker, and some children will be pushed into self-administering insulin when they just aren’t ready yet. This is to say nothing of the number of parents who will lose their jobs in order to be on call to come to school to care for their diabetic children.

And what about extracurricular activities? Countless kids with diabetes can’t participate because few schools have the resources to provide after-hours nurses. Then there’s the issue of nutritionally bankrupt school lunches and long exams that children with diabetes can’t sit through without taking snack breaks. The list goes on, and it’s heartbreaking. But, we’re just here today to talk about your eyes, right? Obviously, that’s impossible—or irresponsible at the very least.

As a primary health care provider, you have an opportunity to connect with patients on a very personal level. Ask more questions and take time to really listen—not just for what you’re expecting to hear, but more importantly, to the unique challenges each individual diabetes patient struggles with.

For specific information on how to communicate with children with diabetes, go to: