Patient Perceptions of Telehealth for Pediatric Type 1 Diabetes During the COVID-19 Pandemic: A Follow-up Study
This study evaluated patient and family perceptions of telehealth at two timepoints (early and late pandemic) in the COVID-19 pandemic. We demonstrated that the desire by families for future telehealth care strengthened significantly from early to later in the pandemic, and virtual care is the preferred option for these visits. This study provided a strong signal for the need for integration of virtual care in future care models.

Usability of Virtual Visits for the Routine Clinical Care of Trans Youth during the COVID-19 Pandemic: Youth and Caregiver Perspectives
This was the first study to assess the usability of gender-related virtual visits using a validated tool specifically developed for the evaluation of newer telemedicine platforms. The results showed a very positive assessment of virtual care by trans youth and their families. A total of 100% of youth and caregivers described virtual appointments as safer or as safe as in-person visits, and 94% of participants would like virtual visits to continue after the pandemic.

Evaluation of telephone and virtual visits for routine pediatric diabetes care during the COVID-19 pandemic
This was the first study to report on a tertiary diabetes centre’s complete transition to telephone and virtual care during the COVID-19 pandemic. As the only tertiary children’s hospital in BC, our program was able to gain insight from many clinical encounters during a short timeframe during the early stages of the pandemic.

Province-Wide Type 1 Diabetes Care Plan for Children in the School Setting
This was the first evaluation of a Canadian provincial diabetes at school program and represented the voices of over 200 stakeholders. It established that BC’s diabetes at school program is overall perceived to be safe and is meeting diabetes management needs. This study also set the framework for a pilot program on the use of continuous glucose monitoring in the school setting, and that pilot program has dramatically changed the landscape of diabetes care offered in schools.

Acute kidney injury in diabetic ketoacidosis
This study assessed the proportion of acute kidney injury in children presenting to BC Children's Hospital with diabetic ketoacidosis. Fluid management in diabetic ketoacidosis has been guided in large part by concern for cerebral edema; however, there are other possible outcomes of our standard of care treatment, such as kidney injury. This study was the first large-scale assessment for acute kidney injury in children with diabetic ketoacidosis, and it was the first study to document the high proportion of children with diabetic ketoacidosis who also develop acute kidney injury. Acute kidney injury is concerning because it is associated with increased morbidity and mortality as well as increased risk of chronic renal disease, a finding that is especially relevant among children who are already at risk for diabetic nephropathy.

Coaching for parents of children with type 1 diabetes
This study evaluated the impact of providing a behavioural approach called coaching for families of children with type 1 diabetes. This novel study brought together the diabetes team with the staff of the New Knowledge & Innovation division to integrate a coach into the diabetes team. The coach worked directly with families of children with type 1 diabetes. Coaching was well received by families who perceived significant benefits. Adding a coach into diabetes care supported families in a way that was unique from their routine clinical care.