We welcomed Carla Cox, CDCES to The Huddle to talk about the value of diabetes camps. Carla has volunteered for diabetes camps across the globe for many years. In this episode, she shares valuable insights on psychosocial and practical benefits of these camps and how healthcare professionals in the diabetes community can get involved.
To learn more about diabetes camps and find or support camps near you, visit the Diabetes Education & Camping Association at: Diabetes Education & Camping Association – Uniting the Global Diabetes Camping Community through Education and Leadership (diabetescamps.org)
To access training modules provided by the American Diabetes Association, visit: American Diabetes Association | Research, Education, Advocacy
Kirsten:
Hello and welcome to ADCES’s podcast, “The Huddle: Conversations with the Diabetes Care Team”. In each episode, we speak with guests from across the diabetes care space to bring you perspectives, issues and updates that elevate your role, inform your practice and ignite your passion. I'm Kirsten Yehl, Associate Director for Research and Proposals at the Association of Diabetes Care and Education Specialists. Today we're joined by Carla Cox. Carla is a certified diabetes care and education specialist and certified insulin pump and CGM trainer affiliated with Mountain Vista Medicine in South Jordan, Utah. She's also the host of Ask the Experts with the American Diabetes Association. For many years, Carla has volunteered for diabetes camps from across the globe to her hometown. In today's conversation, she shares valuable insight on the benefits of diabetes camps and how you can get involved. Carla, welcome to the huddle.
Carla:
Thank you very much. I'm excited to be here.
Kirsten:
Well, it's every year at this time that I'm reaching out to you because it's summer camp season. And I always think about it because I have the best memories of summer camp when I was a kid and you are my go-to resource for camp, specifically diabetes camps. So really happy that you're joining our conversation today. But before we jump into our conversation, I know so many people in the association do know you, but maybe you can introduce yourself for those that maybe don't know you yet.
Carla:
Sure. So I am a dietitian and exercise physiologist working with lots of aspects of the Association of Diabetes, Care and Education Specialists. I work in pediatrics right now and my favorite thing in all of the work that I do is I love camps. I love camps because I think it's great for kids. I think it's great for the medical professions, particularly young people starting out or changing careers to get into type 1 diabetes pediatrics. And it's also for me. So I can be very selfish about this because every time I go to camp, I learn something. I've been doing this for 35 years and I still learn something from the kids. I learned something from parents when they pick up their kids. I just think we can all learn so much by going to diabetes camp.
Kirsten:
Well, your passion shines through loud and clear. It's interesting that one of the questions I was going to ask you is, you know, what makes diabetes camps so special and what keeps bringing you back year after year? And you just said it, right? That you learn like everybody learns. You know, we always think it's just the kids, but everybody, the parents, care providers, people learn. But maybe you can elaborate on that. Like what really brings you back year after year?
Carla:
Well, I think that's it. I mean, I love working with kids, right? And I feel also selfishly a little important when I go, because I can provide kids with knowledge, work with them on a one-on-one basis when they ask questions. And I feel like I can give them the correct answers. So that always makes me feel like, oh, I can kind of fulfill a part of my desire and things I like to do. The other thing I have done is I've really mixed it up. So I don’t go to the same camp every year. Last year I went to seven camps, so you can see I'm a little over the top, I'm a little bit of a campaholic.
But one of the things I've started doing is I'm lucky enough to be invited to do some of the Riding on Insulin camps. So I do some camps that are week long camps where you stay overnight. I do some family camps, which is what Riding on Insulin is about, and it's usually just one or two days of surfing or bike riding or snow skiing or snowboarding. So by mixing up the kinds of camps I go to, it's also very fun. So some of them are more family, so I talk to the parents more, and some of them are more kids where they feel maybe a little isolated and we can make them feel a part of this big, beautiful club.
Kirsten:
So the ones you've talked about there, right? Those are sleep away camps mostly, because there’s sleep away camps and then there's day camps, right?
Carla:
Yeah, yeah, and I've usually done the sleep away, though in Utah we actually have a day camp that I'm associated with as well. But the riding on insulin, for example, and some of these other camps that are family camps, the whole family comes, the program is during the day, and then the parents take care of them at night. But it's a wonderful opportunity. For example, let me give you this. So at surf camp, for example, the kids are out surfing and the parents are all sitting on the beach, very few of them surf. And so we have that opportunity to one on one talk about different pumps that are available, different sensors that are available, talk about some of the challenges they have and maybe how I can help coach them on maybe overcoming some of those challenges. So it's really me talking more to the parents in those kinds of situations, right?
Kirsten:
Yeah and the family camps, is that mostly for younger kids or is it like across the board?
Carla:
It's really across the board. So from as young as five or six years old to 17. And what I find with many of these camps, whether they're day camps, whether they're overnight camps, or whether they're these family camps, is most of the kids, when they turn 17, don't wanna go away, they don't wanna leave. So a lot of times they'll come back as counselors, or they'll just beg, can I just come back one more year kind of thing. So it's basically for kids anywhere from, well depending on the program from 4 to 17 and then can they come back as counselors and the answer is almost always yes.
Kirsten:
And you said that this was surfing camp and then you mentioned bike riding. Is it always sports activities?
Carla:
That's a great question. Most of the camps I've been involved in are either residential camps where you have everything, right? You've got swimming, you've got rock climbing, you have crafts, you have all those educational opportunities. So there's lots of those. One thing I'd really like somebody to start, and I don't know that there is one, is a camp for kids who love music. You know, why don't we have a camp for make a beautiful orchestra all with kids with type one diabetes? How cool would that be? So anybody wants to start that, go for it. I mean, I'm really encouraging that.
Kirsten:
Well, so you're getting my neurons charged here because I went to band camp. Yeah, how cool would that be to have a whole band of kids with diabetes? That would be really amazing.
Carla:
Yeah.
Kirsten:
And think about what you could produce at the end.
Kirsten:
So we chatted a couple of weeks ago and we were just talking about scope and numbers. And you mentioned some big numbers. So how many camps are there in, I guess, in the United States and maybe in the world?
Carla:
So those are great questions. And so I did ask the executive director of Diabetes Education Camping Association for those numbers, because he's the one that's most up on that. And it looks like there are about 185 camps in the United States, and that includes 373 sessions. So many of the camps will have two, three, four sessions, and those are all diabetes-specific camps. There are other camps that will include, of course, kids with diabetes, but these are diabetes-specific camps. And the estimate is that there are that many worldwide. So one of the awesome things that I got to do this year was I went to Portugal with our Diabetes Education Camping Association team and we had a exhibit booth. So we met people from all over the world, that was at the International Diabetes Federation. I was so impressed with tiny little resources. You know, we always think we have to put on a camp that's a week long and has 25 doctors, 14 nurses, and you know, I mean, almost to the point of a little bit of absurdity in a way. But I mean, they just have, like, they get together and play soccer. And a lot of the kids don't even have shoes for soccer. They just play on a grass field, or they'll just get together and bring a potluck. You know, it doesn't need to be a big deal, but that's really something that I observed and enjoyed about these international camps. Some of them are just like we have in the U.S. but many of them are just these little pockets of getting kids together so they could share the experience of having type 1 diabetes and not feel isolated.
Kirsten:
Yeah, it's amazing to hear that. And sometimes we maybe need that reminder that maybe it's more about kids getting together, being with their peers. And there's just so many benefits to just that. What are the benefits? So, camp is such a big thing, right? But what are the benefits to the kids?
Carla:
So the research would support, so let's go with the research first, that the psychological part of camp is very positive. In other words, they feel like they're part of a club or a collective group. So many of them are isolated. They may be the only one at school or they may be one other kid that they really don't like who’s in their school that also has type one. Sometimes they have family members that have type one, but many times they are an end of one. They don't know anybody else. So it's that peer group. I can tell wonderful stories. For example, I had, when I was in Montana at the camps, there were kids who went from the time they were eight till they were 17. They became such good friends with other people that had done the same thing.
We actually went on a college backpack trip because they didn't want to quit. And they're still 10 years, 15 years later, texting each other, asking questions, feeling a part of this community and all three of them were solo. They didn't have anybody else in their family who had type 1 diabetes. And I can go on and on and on about that. I have another great story I'll just share quickly is there was a family of four kids with type 1 diabetes. The fourth one was 17 when he got it and he thought he'd escaped this thing. His three sisters had it. So his mom said, well, you're gonna go to camp. Your sisters go to camp, you're gonna go to camp. He goes, no, no, I don't wanna go to camp. I'm 17 years old, I don't need to go to camp. When he left camp, he was crying and he said, I am so glad my mom encouraged me to come. It's one of the best experiences I've ever had in my life. And he has three sisters with diabetes. So it wasn't like he felt isolated, he just, his peers, right? His age group, they went out and they went mountain biking, we went rafting, we did all these things together, and he just felt a part of this team. So really neat stories.
Kirsten:
Yeah, I just love hearing that those stories can happen and those interactions can happen. And they should for all kids, right? They all need those moments. And sometimes it's at that identity building stage, right? Where you get away from your family and you define who you are and everyone should have access to that. But there are maybe some practical benefits too, right?
Carla:
Sure.
Kirsten:
To these kids?
Carla:
I think the self-efficacy is the biggest deal that we see again and again and again in the research. But the other piece of that is kids learn things that they might not do with just their parents' encouragement. I mean, we've all that experience as parents, right? Or our kids listen to somebody else better than they do us, right? So for example, they may give an injection someplace where they've said, no, don't ever put an injection in my stomach or my leg or whatever, and they may give that.
They may decide to start an insulin pump because they see other kids with that and they've been encouraged to do so, but they're like, no, I'm not wearing anything on my body. Well, everyone there pretty much has something on their body and it's no big deal, right? So they might do that. Or they might understand more about ketones. Why do I need to check for ketones? A lot of times at camp, we'll have some high blood sugars and we'll check. And they'll understand why are we checking, right? Rather than just their mother handing them something or forgetting that that's a part of diabetes management since a lot of times kids don't need to do that very often. So all of those things, teachable moments are so precious at camp.
Kirsten:
And I have to say, I've raised two boys. The youngest one is still a teenager, but he's heading off to college next year. They don't listen to me. Doesn't matter what I say, right? Like what I say means nothing. So I totally appreciate that. And I know I'm not the only one. So there's the psychosocial, right? And then there's the practical. Is there any way that they come together? Or is there any other any other benefits or different things you can talk about?
Carla:
Yeah I think that the challenge with this, I mean, obviously we do an A1C on someone that's been at camp for two days or one week, we're not gonna see a change. It appears that the behavior changes and things that they're doing like better carb counting, wearing a pump that they didn't wear before, etc, the momentum of camp lasts approximately three months. And then it kind of fades away. They're in the same family situation, they're not getting that peer support, and it may start fading away. So yes, I think the practical goes into clinical outcomes, but it doesn't last as long as we'd like it to.
So one of the things that we need to think about as educators is how do we touch base with these kids in some kind of get together to link camp to camp, right? So if they love to go to camp in July, what do we do in September or January or April to make it all link? Now they could go to a camp that's a ski camp, they could go to a surf camp. I mean they could do these things, but we could also do things individually close to home that's not so hard. I'm going to give you an example. So we just had a gentleman move here from Old Dominion's, now at Weber State University, and he has a program called Reach. And what it is is monthly for four hours, he invites kids to get together to do something. And it's usually physical but I'm encouraging to do maybe a music one. But it's usually physical like a climbing wall at the university or a swim meet or something. And links those by doing it every month. Kids can come four to five hours, very little fee, and they can come—or no fee depending upon how his funding is going. He’s just starting that here in Utah and he already has 50 kids signed up, that's the max.
Kirsten:
Wow.
Carla:
So it's not like you will offer people won’t come, they'll come.
We used to do a climbing wall. When I was in Montana, we had a climbing wall and the owner of the climbing wall gave us discounts. We had 30 to 40 kids come and their parents came and we could all talk and once again, it was a linking event. So we need to think about what can we do that's not costly but that will help link the practical things, the psychological things that go from being a camp to being a camp again. So as Diabetes Care and Education specialists, we really need to think about what can we do for kids to bridge the time between one camp and the next. Besides, it's fun. I mean, you'll have fun, they'll have fun, their parents will have fun. I mean, it's not like it's a drag. It will probably be volunteer, though sometimes you can get some funding. There's actually quite a bit of funding available if you dig for it. But yeah, it's just, it’s awesome.
Kirsten:
So, and I love the example that you shared too, because that just shows that there's such a hunger for these programs, and it's such an opportunity, especially for the diabetes care and education specialists. Right, because this is what we do. We meet kids and people with diabetes where they're at. This is the specialty that really understands what people need, and we're in the perfect position to make that connection. And I think, and we've talked about this before. Like, what an opportunity for even like students or people who are learning to be a diabetes care or studying to be a diabetes care and education specialist. It sounds like an intense period that people can jump in and learn and be connected to all aspects of the of the care circle, right?
Carla:
Absolutely. The learning curve is huge. It's absolutely huge. I mean, you don't learn this in school. I don't care how much school you go to. I don't care how many webinars you take. You learn it by being there. It's incredible. And if you don't feel like you want to volunteer or be there, make sure that you refer your kids so that they will be there, right? You can look it up on websites. AIDA has a bunch of camps. DECA, as I mentioned before, Diabetes Education Camping Association. If you really want to go outside your box do international. I couldn't believe how many people asked me if I could come to their camp, you know, in Africa or wherever I'd love to, I'd love to go to all of them. But I think that we need to think about that is making sure that we are encouraging our kids to attend these camps because I think it really does a lot for their mental health.
Kirsten:
And I love all those resources you just shared too. So afterwards I'll connect with you and we'll make sure that we get those in the resource section too so people can access those. A lot of what we've talked about today, which has been really cool is, yes diabetes camps are an amazing opportunity for kids with diabetes and their family, but also an amazing opportunity for diabetes care and education specialists. So I'm going to turn this over to you. Anything, any calls to action or anything you want to ask of our listeners?
Carla:
Yeah, so I think ways to learn about where the camps are, once again, is to look at the Diabetes Education Camping Association, DECA website, and you can see where they are internationally. So if you, again, want to go outside the box, go to Costa Rica be it. You can look it up. And the other thing is at the American Diabetes Association, I've been lucky enough to be a part of a small group of professionals. And we put together a package of 16 modules the diabetes 101 all the way through the sophisticated AID systems, how do you use them at camp, and they're available for credits. So you can go on to their ADA website and find them there and their modules for camp. I will also pitch that they're totally appropriate for school nurses. So it's another way to share information that the diabetes community is putting out. But yeah, become involved, volunteer, share, encourage your kids to come. And you know, the other thing that I will also pitch is I wish we did more of this for adults.
Kirsten:
Mm-hmm.
Carla:
So there's connected emotion that does a lot of physical stuff for adults. But you know, what fun would it be if someone wanted to put together a travel thing for older people with type 1 diabetes, for example, or middle-aged people with diabetes that want to travel, but they want a companion that will help educate them at the same time? You know, we look at diabetes as it's an educational opportunity when you first get diagnosed. But then what about the rest of your life? Well, it changes and the needs of diabetes change and the technology changes. And so updating people, I mean, what a fun thing to do is to go on a vacation somewhere with 10 people that are in their middle age trying to make diabetes work for them. So I'm going to pitch that out there if anyone wants to put one together.
Kirsten:
Okay, the neurons are charged. I'm ready to go. But Carla, I have truly enjoyed this conversation as always. And I hope you come back for another one and we can do this again, certainly about camps, but anything you want to talk about, I love these conversations with you.
Carla:
Well, thank you for having me. It's really fun to work with you.
Kirsten:
Thank you for listening to this episode of The Huddle. Make sure to download the resources discussed on today's episode. You can find them linked in the show notes and at diabeteseducator.org/podcast. And remember, being an ADCES member gets you access to many resources, education, and networking opportunities. Learn about the many benefits of ADCES membership at diabeteseducator.org/join. The information in this podcast is for informational purposes only. It may not be appropriate or applicable for your individual circumstances. This podcast does not provide medical or professional advice and is not a substitute for consultation with a healthcare professional. Please consult your healthcare professional for any medical questions.