Building Competency in Diabetes Education THE ESSENTIALS

4-32 | CHAPTER 4

• Development of relationships, possibly marriage and family-planning issues. Pregnancy poses extra challenges when diabetes is added to the equation. Young women should receive pre-pregnancy counselling about the need for good blood glucose control to promote an optimal outcome. In the case of an unplanned pregnancy, young women should receive immediate medical care. Impotence or sexual dysfunction due to poor glycemic control may begin to be a concern.

Table 7: Interventions for young adulthood INTERVENTIONS

Challenge

Intervention

1. Transition care

Referral to transition program

•

Start preparing in mid teens

•

Encourage collaborative approach

•

2. Career path

• Discuss career choices in light of financial/insurance issues • Refer to available sources of support • Education and counselling

3. Pregnancy

• Type 1 and type 2 essential to have preconception counselling

4. Relationships

• Issues re: adjustment, informing partner, sexual maturity

Middle-age adults By middle age, adults are generally settled in their careers and family life. Erickson describes the developmental task for this age group as “generativity versus stagnation” (37). This is the stage where stability is sought and lifelong relationships are formed. For some adults, however, and for those with diabetes, in particular, this is also a time that may be marked by the appearance of chronic health issues, such as hypertension, dyslipidemia and cardiovascular issues. Middle age is often accompanied by: • An increase in weight. • Loss of strength, muscle tone and stamina may become evident. • Women experience the onset of menopause.