Building Competency in Diabetes Education THE ESSENTIALS

CHANGES ACROSS THE LIFESPAN| 4-5

Note: The term “child” refers to individuals 0 to 18 years of age, and the term “adolescent” for those 13 to 18 years of age, as per the Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada (2018 Guidelines) ( 2) . The term “elderly” generally refers to those >70 years of age, as per the 2018 Guidelines (3). This chapter is not intended to repeat or replace texts written on psychosocial responses to chronic illness. See the texts listed in References or Other Resources for more depth or insights into this complex issue. See also Chapter 11: Self-Management Education and Support: Program Development.

Figure 2. Overview: Infants to Adolescents

Infant Toddler Preschool

Adolescents

School-age

Diabetes management in the early years is distinctly different than adulthood (2,4). The frequently quoted statement “children are not little adults” reflects the difference in pathophysiology, epidemiology, treatment modalities and developmental tasks that are specific to the child with diabetes. It is recognized that the diagnosis of diabetes at any stage in life carries an emotional, psychological and financial burden (5). These factors are accentuated when diabetes, be it type 1 or type 2 diabetes, is diagnosed in early childhood or adolescence. Families and the child often grieve the loss of health or the ‘normal childhood’ they had anticipated. The future is hard to imagine. During the early years, the foundation of the personality is being laid and patterns of behaviour are being established. How diabetes is dealt with in these years will have a lifelong effect (6,7).

Since there are behavioural interventions and medical needs specific to this population, it is recommended that all children and adolescents with type 1 or type 2 diabetes be referred to an interdisciplinary pediatric health-care team (2,4,7-9).