By Dirk Hoffman
Published October 6, 2023
After a multi-year hiatus due to the COVID-19 pandemic, the D-Link diabetes support group has resumed in-person monthly meetings for teenagers with diabetes.
Founded and run by Jacobs School of Medicine and Biomedical Sciences medical students, D-Link provides peer interaction and a proactive approach to managing the disease for Western New York youths ages 12 to 18.
Lucy D. Mastrandrea, MD, PhD, a professor in the Department of Pediatrics and Division Chief of Pediatric Endocrinology/Diabetes, has served as the faculty mentor for D-Link since its inception in 2007.
It was founded by then-students Laura (Cataldi) Young, MD, who is now a clinical assistant professor of pediatrics at the Jacobs School and a pediatric endocrinology specialist at UBMD Pediatrics in Buffalo; and Robert Borowski, DO, an endocrinology, diabetes and metabolism specialist who trained and practiced in Buffalo.
“Laura and Bob did a nice job creating the mechanism for it to continue through the years and for new medical students to take the lead,” Mastrandrea says.
Mastrandrea says the medical students plan and run the meetings and she acts as a consultant while also spreading the word about the support group to her patients.
“I also serve as a sounding board to discuss any difficult conversations that come up at the meetings,” she says. “We have met to set ‘ground rules’ for the attendees.”
Alaina Kenny, a second-year medical student, is one of eight students currently involved with facilitating the group, which meets on the last Thursday of every month from 6:30 to 7:45 p.m. at the Williamsville Branch Library. (This month’s meeting however is scheduled for Oct. 19).
“We are still very much in the process of rebuilding our numbers of interested teens,” she says. “It’s somewhat typical to see reduced numbers during the summer, so we are hoping to see increased numbers in the coming months.”
Kenny says the medical students usually plan out an agenda beforehand focused on a specific topic and how it relates to the attendees’ experience with diabetes.
“However, we always open it up to the teens and try to let the conversation flow to whatever aspect of diabetes they want to talk about that day,” she says.
“I've noticed that the teens who attend really enjoy and benefit from meeting and talking to other people their age who also have diabetes,” Kenny says. “Many of them don't know anyone else with diabetes, and they've said that it can be an isolating experience. It means a lot to them to have other teens relate to their specific struggles and experiences.”
Allen Murphy, a third-year medical student, says those running the meetings strive to help teens with Type 1 diabetes navigate things like puberty (which can affect diabetes control), sports, eating choices, exercise and risky behaviors that traditionally accompany the teenage years.
“We have been able to see some teens have their frustrations and their everyday work of managing diabetes be related to from others,” he says. “Even in a small session, it is nice for a teen to see that others have similar issues. They were able to find some humor in the situation as well.”
“The specific topics we discuss too can help the teens develop strategies to tailor their diabetes management to the things they are doing day-to-day,” Murphy says. “For example, we may discuss sports and movement with diabetes and ways to secure insulin pumps while doing things like dance or football practice.”
“We may also give the teens ways to discuss diabetes with teachers or peers as many people may have questions or preconceived notions about their diabetes that frequently come up.”
Mastrandrea points out that adolescence is a very challenging developmental period that includes a lot of psychosocial changes.
“Learning how to incorporate the day-to-day tasks of diabetes care can be imposing when teenagers are managing school, sports, friends and family,” she says. “In addition, the normal physiologic changes of puberty can make diabetes management more difficult; thus, they have to be more attentive to their diabetes care.”
Mastrandrea also notes that individuals with chronic disease have increased risk of mood disorders. “Depression and anxiety greatly impact diabetes control,” she says.
One of the benefits for the medical students who work with D-Link is learning to understand the disease from the patient perspective.
“As a medical student, I’ve learned a lot about the pathophysiology of diabetes, but I didn’t previously know much about the everyday reality of managing the disease,” Kenny says. “The teens have taught me a lot about the specific treatment devices that they use and the logistical challenges that they deal with on a regular basis.”
Mastrandrea says she believes medical students gain a lot of skills when they participate with D-Link.
“They have to organize the meetings and market the group. They also work with a fun patient population who benefit from seeing young adults such as the medical students who are interested in their lives,” she says.
“I also believe the medical students learn the process of communicating and navigating relationships with patients through their participation in this group.”
D-Link is partnered with the WNY chapter of Juvenile Diabetes Research Foundation, and it helps promote its meetings.
Mastrandrea says the D-Link team sends its schedule to her to share with patients at the Pediatric Endocrinology and Diabetes Center at Conventus, which is a partnership between UBMD Pediatrics and Oishei Children’s Hospital. Mastrandrea is the center’s medical director.
“We provide contact access information and access to D-Link to our patients in clinic and at their diagnosis,” she says.
In addition to the monthly meetings, medical students have also gone out to youth after-school programs in the area and led educational activities related to diabetes.
Murphy says among those efforts were trips to the Moot Center and the Buffalo Boys and Girls Club to teach children and teens about Type 1 and Type 2 diabetes through activities demonstrating how insulin and carbohydrate metabolism works on a basic level.
“The activity somewhat resembled musical chairs and got the kids moving while they learned about the two diseases and insulin signaling in a person without diabetes,” he says.
Murphy also stresses that D-Link is always looking for ways to get more members and do more in the community.
“If you are a medical student and want to directly impact a club with ideas, D-Link is very accessible in that regard.”