Building Competency in Diabetes Education THE ESSENTIALS

4-14 | CHAPTER 4

Table: 3 Interventions for the infant, toddler, preschool stage INTERVENTIONS

Challenge

Intervention

1. Parental reaction and actions

Counselling, education, support

•

2. Hypoglycemia

Review of glycemic targets

•

Use of CSII and continuous monitoring

•

Training re glucagon kit

•

3. Irregular eating

Food is non-negotiable

•

• Give insulin following meal if necessary • Reward behaviour by other meals • Adjust insulin/CSII to more frequent intake

4. Caregivers

Education, communication, support

•

CSII = continuous subcutaneous insulin infusion

School-age children Physical growth continues to be rapid in the school-age child. BG control can be more collaborative than in babies and younger children, since most school-age children can recognize hypoglycemia and initiate treatment. This is a stage of industry, in which children learn by doing, playing, experimenting, imitating and challenging. The peer group becomes very important, and it is often undesirable to be “different,” as a child with diabetes might feel. The child will be asserting their independence and they will be away from home more often; he/she and others (e.g. teachers, coaches and parents) need to be prepared for this. The goal for this age is to adjust to social influences and to develop competence and confidence in their diabetes management. Parents and the child him/herself, where appropriate, may need assistance with the following (35,38): • Remaining appropriately involved in the child’s diabetes care in a way that is viewed by the child as supportive and nonjudgmental. • Informing school personnel of the child’s diabetes.