Building Competency in Diabetes Education THE ESSENTIALS

CHANGES ACROSS THE LIFESPAN| 4-19

the high rate of congenital anomalies in infants born to adolescent girls with diabetes, all adolescent girls should be counselled in appropriate birth control measures and this should be discussed and reinforced at each visit (2). If a pregnancy is planned, there are specific preconception measures that will need to be undertaken well before the pregnancy. Refer to the “Diabetes and Pregnancy” chapter in the 2018 Guidelines for more detail. Technology in this age As parental influence decreases in the adolescent years, peer and societal influences increase (4,10). Technology has had a significant impact on how we experience these influences and how we manage diabetes in this age group (18). The benefits of technology are that it has brought the world to us, connected us in ways that we would never have previously imagined and given us more sources of information than we ever thought possible. Insulin pumps with CGM (54), smartphones with innumerable apps, and social media sites are only a few examples of how technology has impacted diabetes management. However, technology also has its drawbacks. It has been blamed for the increasing rates of obesity in youth by providing easily accessible entertainment and influencing food choices by making fast foods so appealing and accessible. The problem with this wealth of information, is that there is a general lack of knowledgeable guidance which contributes to a greater sense of confusion for the adolescent. As Erickson has described in his “Stages of Development” (3,55), the adolescent has the task of differentiating himself from his family and developing his own identity. Termed “role identity versus role confusion”, the adolescent is experiencing the world around him/her, engaging in more social interactions, more peer involvement, and becoming aware of ethical issues (4,10,18). As diabetes educators, we are cognizant that this is the age where experimentation takes place and responsibilities for the tasks involved in diabetes management are often neglected (36,56). Our goal is to simplify diabetes management and have it fit into the teen’s life in the least conspicuous way. To echo the voice from this age, “we just want to fit in”. Technology, if used with guidance, can be an asset in this endeavor, giving immediate results, recording events electronically and using applications for numerous tasks. The educator who is familiar with this age-appropriate technology will have a greater chance of motivating the teenager to engage in their diabetes care (4,18,54).