Building Competency in Diabetes Education THE ESSENTIALS

4-20 | CHAPTER 4

Table 5: Interventions in adolescence

INTERVENTIONS

Challenge

Intervention

1. Interdependence in diabetes self-management

• Counselling with family and teen has proven to be more successful • Parental involvement necessary • Specialized care from pediatric teams effective • Keep communication open

2. Experimenting: alcohol, drugs, smoking

Experienced diabetes teams

•

Group activities and peer mentors

•

Education, safety emphasized

•

3. Insulin omission

• Monitoring of glycemic control essential • Identifying cause; confront, refer prn

Observe for weight fluctuations

4. Psychological disorders:

•

Nutrition referral essential

Disordered eating and eating disorders Depression Anxiety

•

Encourage regular eating times

•

• Psychiatric referral for eating disorders of anorexia, diabulimia, depression

5. Contraception counselling

Education/group counselling

•

Non-judgemental approach

•

Peer counsellor effective

•

Open communication

•

6. DKA

Public awareness campaigns

•

Parental involvement

•

Monitor insulin use

•

DKA = diabetes ketoacidosis; prn = as needed

The separate pediatric chapters in the 2018 Guidelines contain several recommendations specific to the psychosocial aspects of care for children and adolescents (2,8). • All children should receive guidance promoting healthy eating, limiting sugar sweetened beverage intake [Grade C, Level 3], limiting screen time, improving sleep quantity and