Building Competency in Diabetes Education THE ESSENTIALS

4-16 | CHAPTER 4

Table 4: Interventions for the school-age child INTERVENTIONS

Challenge

Intervention

1. Adjusting to school/social activities

Educating staff, teachers, to diabetes regiment

•

• Discussing signs, symptoms and treatment of hypoglycemia • Supporting child in developing independence in self-management activities • Continuing communication

2. Intensifying glycemic control

More frequent injections

•

More frequent SMBG

•

CSII and continuous monitoring

•

3. Child acquiring more independence in care of their diabetes

Counselling with parents

•

Attempt one task at a time

•

Supervision essential

•

CSII = continuous subcutaneous insulin infusion; SMBG = self-management blood glucose

Adolescents The teen years are a time of rapid physiological and psycho-emotional change, as well as a time when optimal BG control is very difficult to achieve. With the hormonal influence of puberty, insulin requirements are increased. Limits of parental control are tested, and the peer-group influence continues to grow in importance. Parents are encouraged to remain involved in their child’s diabetes management at some level right through adolescence (36). The ultimate goal is interdependence rather than independence from the parents (30). Erickson describes the developmental task in this age as, “role identity versus role confusion” (37). The adolescent is questioning “Who am I? What can I be?” They are experiencing the complexities of life with a heavy emotional influence. However, they often do not have the emotional maturity to make appropriate decisions. They are also adapting to physiological changes with hormonal changes altering their body image. During this stage, the development of skills for life is a major challenge.