Diabetes education - International Diabetes Federation

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Lifelong learning
balanced with the increasingly demanding
regimens that are developed
to optimize blood glucose control in
type 1 diabetes. Diabetes educators
need to ensure that children are able
to develop a sense of competence and
confidence in managing their diabetes
and avoid ‘burn-out’, particularly during
difficult periods such as puberty.
This will help to ensure that young
people with diabetes can face the future
with resilience and optimism, and
continue to benefit from advances in
diabetes treatment.
Diabetes educators
should ensure that
children avoid ‘burnout’,
particularly
during difficult periods
like puberty.
Special concerns
Children with diabetes are, first and
foremost, children. Diabetes education
must be age-appropriate in content and
delivery. Educators must be sensitive
to the normal developmental tasks of
children and try to work diabetes management
into the normal activities of
childhood – sports, trips, parties, and
so on. This will help young people with
diabetes to balance a sense of belonging
with a sense of uniqueness.
There should be ongoing assessment
of each child’s functioning – emotionally,
with peers, at school, and within
the family. There is also a need for
ongoing assessment of mental health
barriers to optimal control, such as
depression, anxiety disorders, and eating
disorders, which put the child with
diabetes at high-risk for poor blood
glucose control.
Conclusion
We live in an era in which we know
that intensive management of type 1
diabetes is the best choice to prevent
the long-term complications of the condition.
Moreover, we know that all children
living with type 1 diabetes need
two teams to manage the complex
regimen associated with this intensive
management: a multidisciplinary diabetes
care team, and a family team.
In addition, children with type 1 diabetes,
wherever they live, bring specific
needs to diabetes education: the need
for all caregivers to receive diabetes
education; the need for families to
learn how to negotiate the sharing of
diabetes responsibilities; the need for
quality of life (of children and parents)
to be balanced with the burdens of the
diabetes treatment regimen; and the
need for children to achieve a sense
of competence and confidence in managing
diabetes as they develop into
young adulthood.
There are special concerns involved in
providing diabetes education to children
with type 1 diabetes. Diabetes education
must be age-appropriate in content
as well as delivery. The diabetes treatment
regimen must be worked into the
normal tasks of child and adolescent
development. Diabetes education must
include ongoing assessment of emotional
functioning, especially with respect to
depression, anxiety, and eating disorders.
Once the child and family have
full access to insulin and critical diabetes
supplies, attention to these specific needs
and special concerns in diabetes education
will help to insure that young people
with type 1 diabetes and their families
face a healthier, happier future.
Barbara Anderson
Barbara Anderson is a clinical
psychologist and behavioural scientist.
She is Professor of Pediatrics at Baylor
College of Medicine, Houston, Texas, USA.
References
1 Silverstein J, Klingensmith G, Copeland K,
et al; A Statement of the American
Diabetes Association. Care of children
and adolescents with type 1 diabetes.
Diabetes Care 2005; 1: 186-212.
2 International Society for Pediatric and
Adolescent Diabetes. Consensus Guidelines
for the Management of Type 1 Diabetes
Mellitus in Children and Adolescents. ISPAD.
Medical Forum International. Zeist, 2000.
3 Diabetes Control and Complications Trial
Research Group. The effect of intensive
treatment of diabetes on the development
and progression of long-term complications
in insulin-dependent diabetes mellitus.
N Engl J Med 1993; 329: 977-86.
4 Epidemiology of Diabetes Interventions and
Complications Research Group. Beneficial
effect of intensive therapy of diabetes during
adolescence; outcomes after the conclusion
of the Diabetes Control and Complications
Trial. J Pediatr 2001; 139: 804-12.
5 Anderson BJ, Svoren B, Laffel L. Initiatives
to promote effective self-care skills in young
patients with diabetes. Disease Management
and Health Outcomes 2007; 15: 101-8.
November 2007 | Volume 52 | Special Issue