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Pediatric Diabetes Education: A Family Affair

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Educating Your Patient with Diabetes

Part of the book series: Contemporary Diabetes ((CDI))

Abstract

Implementation of findings of the Diabetes Control and Complications Trial (DCCT) has dramatically changed diabetes care for pediatric patients. The purpose of this chapter, within the broader scope of this book, is to examine unique issues in caring for children and adolescents with diabetes and provide a synopsis of current clinical practice and research findings relevant to care of this population. Normative aspects of growth and development provide background to the need for tailoring diabetes education and self-care expectations according to a child’s age and developmental stage. The role of the diabetes educator working with children and families during specific transition points through childhood is examined: school issues, camping diabetes style, adolescence, and transition to young adulthood.

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References

  1. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The Diabetes Control and Complications Trial Research Group. N Engl J Med 1993;329(14):977–86.

    Article  Google Scholar 

  2. Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus: Diabetes Control and Complications Trial. Diabetes Control and Complications Trial Research Group. J Pediatr 1994;125(2):177–88.

    Article  Google Scholar 

  3. Dabelea D, Bell RA, D’Agostino RB, Jr., et al. Incidence of diabetes in youth in the United States. JAMA 2007;297(24):2716–24.

    Article  PubMed  Google Scholar 

  4. Liese AD, D’Agostino RB, Jr., Hamman RF, et al. The burden of diabetes mellitus among US youth: prevalence estimates from the SEARCH for Diabetes in Youth Study. Pediatrics 2006;118(4):1510–8.

    Article  PubMed  Google Scholar 

  5. Incidence and trends of childhood Type 1 diabetes worldwide 1990–1999. Diabetes Med 2006;23(8):857–66.

    Article  Google Scholar 

  6. Green A, Patterson CC. Trends in the incidence of childhood-onset diabetes in Europe 1989–1998. Diabetologia 2001;44 Suppl 3:B3–8.

    Article  PubMed  Google Scholar 

  7. Roche EF, Menon A, Gill D, Hoey H. Clinical presentation of type 1 diabetes. Pediatr Diabetes 2005;6(2):75–8.

    Article  PubMed  Google Scholar 

  8. Dabelea D, Pettitt DJ, Jones KL, Arslanian SA. Type 2 diabetes mellitus in minority children and adolescents. An emerging problem. Endocrinol Metab Clin North Am 1999;28(4):709–29, viii.

    Article  CAS  Google Scholar 

  9. Effect of intensive therapy on the microvascular complications of type 1 diabetes mellitus. JAMA 2002;287(19):2563–9.

    Article  Google Scholar 

  10. White NH, Cleary PA, Dahms W, Goldstein D, Malone J, Tamborlane WV. Beneficial effects of intensive therapy of diabetes during adolescence: outcomes after the conclusion of the Diabetes Control and Complications Trial (DCCT). J Pediatr 2001;139(6):804–12.

    Article  PubMed  CAS  Google Scholar 

  11. Litton J, Rice A, Friedman N, Oden J, Lee MM, Freemark M. Insulin pump therapy in toddlers and preschool children with type 1 diabetes mellitus. J Pediatr 2002;141(4):490–5.

    Article  PubMed  Google Scholar 

  12. DiMeglio LA, Pottorff TM, Boyd SR, France L, Fineberg N, Eugster EA. A randomized, controlled study of insulin pump therapy in diabetic preschoolers. J Pediatr 2004;145(3):380–4.

    Article  PubMed  CAS  Google Scholar 

  13. Fox LA, Buckloh LM, Smith SD, Wysocki T, Mauras N. A randomized controlled trial of insulin pump therapy in young children with type 1 diabetes. Diabetes Care 2005;28(6):1277–81.

    Article  PubMed  CAS  Google Scholar 

  14. Wilson DM, Buckingham BA, Kunselman EL, Sullivan MM, Paguntalan HU, Gitelman SE. A two-center randomized controlled feasibility trial of insulin pump therapy in young children with diabetes. Diabetes Care 2005;28(1):15–9.

    Article  PubMed  Google Scholar 

  15. Mack-Fogg JE, Orlowski CC, Jospe N. Continuous subcutaneous insulin infusion in toddlers and children with type 1 diabetes mellitus is safe and effective. Pediatr Diabetes 2005;6(1):17–21.

    Article  PubMed  Google Scholar 

  16. Jeha GS, Karaviti LP, Anderson B, et al. Insulin pump therapy in preschool children with type 1 diabetes mellitus improves glycemic control and decreases glucose excursions and the risk of hypoglycemia. Diabetes Technol Ther 2005;7(6):876–84.

    Article  PubMed  CAS  Google Scholar 

  17. Silverstein J, Klingensmith G, Copeland K, et al. Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association. Diabetes Care 2005;28(1):186–212.

    Article  PubMed  Google Scholar 

  18. Mortensen HB, Hougaard P. Comparison of metabolic control in a cross-sectional study of 2,873 children and adolescents with IDDM from 18 countries. The Hvidore Study Group on Childhood Diabetes. Diabetes Care 1997;20(5):714–20.

    Article  PubMed  CAS  Google Scholar 

  19. Danne T, Mortensen HB, Hougaard P, et al. Persistent differences among centers over 3 years in glycemic control and hypoglycemia in a study of 3,805 children and adolescents with type 1 diabetes from the Hvidore Study Group. Diabetes Care 2001;24(8):1342–7.

    Article  PubMed  CAS  Google Scholar 

  20. Rosilio M, Cotton JB, Wieliczko MC, et al. Factors associated with glycemic control. A cross-sectional nationwide study in 2,579 French children with type 1 diabetes. The French Pediatric Diabetes Group. Diabetes Care 1998;21(7):1146–53.

    Article  PubMed  CAS  Google Scholar 

  21. Anderson B, Ho J, Brackett J, Finkelstein D, Laffel L. Parental involvement in diabetes management tasks: relationships to blood glucose monitoring adherence and metabolic control in young adolescents with insulin-dependent diabetes mellitus. J Pediatr 1997;130(2):257–65.

    Article  PubMed  CAS  Google Scholar 

  22. Laffel LM, Vangsness L, Connell A, Goebel-Fabbri A, Butler D, Anderson BJ. Impact of ambulatory, family-focused teamwork intervention on glycemic control in youth with type 1 diabetes. J Pediatr 2003;142(4):409–16.

    Article  PubMed  Google Scholar 

  23. Anderson BJ, Vangsness L, Connell A, Butler D, Goebel-Fabbri A, Laffel LM. Family conflict, adherence, and glycaemic control in youth with short duration Type 1 diabetes. Diabetes Med 2002;19(8):635–42.

    Article  Google Scholar 

  24. Laffel LM, Connell A, Vangsness L, Goebel-Fabbri A, Mansfield A, Anderson BJ. General quality of life in youth with type 1 diabetes: relationship to patient management and diabetes-specific family conflict. Diabetes Care 2003;26(11):3067–73.

    Article  PubMed  Google Scholar 

  25. Weinger K, O’Donnell KA, Ritholz MD. Adolescent views of diabetes-related parent conflict and support: a focus group analysis. J Adolesc Health 2001;29(5):330–6.

    Article  PubMed  CAS  Google Scholar 

  26. Piaget J. Piaget’s theory. In: Mussen P, ed. Carmichael’s manual of child psychology. New York: John Wiley & Sons; 1970.

    Google Scholar 

  27. Erikson E. Identity, youth and crisis. New York: W.W. Norton & Co., Inc.; 1968.

    Google Scholar 

  28. La Greca AM. It’s “all in the family”: responsibility for diabetes care. J Pediatr Endocrinol Metab 1998;11 Suppl 2:379–85.

    PubMed  Google Scholar 

  29. Butler D, Lawlor MT. It takes a village: Helping families live with diabetes. Diabetes Spectr 2004;17(1):26–31.

    Article  Google Scholar 

  30. Wiebe DJ, Berg CA, Korbel C, et al. Children’s appraisals of maternal involvement in coping with diabetes: enhancing our understanding of adherence, metabolic control, and quality of life across adolescence. J Pediatr Psychol 2005;30(2):167–78.

    Article  PubMed  Google Scholar 

  31. Type 2 diabetes in children and adolescents. American Diabetes Association. Diabetes Care 2000;23(3):381–9.

    Article  Google Scholar 

  32. Atkinson A, Radjenovic D. Meeting quality standards for self-management education in pediatric type 2 diabetes. Diabetes Spectr 2007;20(1):40–6.

    Article  Google Scholar 

  33. Zeitler P, Epstein L, Grey M, et al. Treatment options for type 2 diabetes in adolescents and youth: a study of the comparative efficacy of metformin alone or in combination with rosiglitazone or lifestyle intervention in adolescents with type 2 diabetes. Pediatr Diabetes 2007;8(2):74–87.

    Article  PubMed  CAS  Google Scholar 

  34. Halvorsen M, Yasuda P, Carpenter S, Kaiserman K. Unique challenges for pediatric patients with diabetes. Diabetes Spectr 2005;18(3):167–73.

    Article  Google Scholar 

  35. Mensing C, Boucher J, Cypress M, et al. National standards for diabetes self-management education. Diabetes Care 2007;30 Suppl 1:S96–S103.

    Article  PubMed  Google Scholar 

  36. Swift PG. Diabetes education. ISPAD clinical practice consensus guidelines 2006–2007. Pediatr Diabetes 2007;8(2):103–9.

    Article  PubMed  Google Scholar 

  37. Gage H, Hampson S, Skinner TC, et al. Educational and psychosocial programmes for adolescents with diabetes: approaches, outcomes and cost-effectiveness. Patient Educ Couns 2004;53(3):333–46.

    Article  PubMed  Google Scholar 

  38. Clar C, Waugh N, Thomas S. Routine hospital admission versus out-patient or home care in children at diagnosis of type 1 diabetes mellitus. Cochrane Database Syst Rev 2007(2):CD004099.

    PubMed  Google Scholar 

  39. Grey M, Boland EA, Davidson M, Li J, Tamborlane WV. Coping skills training for youth with diabetes mellitus has long-lasting effects on metabolic control and quality of life. J Pediatr 2000;137(1):107–13.

    Article  PubMed  CAS  Google Scholar 

  40. Anderson BJ, Wolf FM, Burkhart MT, Cornell RG, Bacon GE. Effects of peer-group intervention on metabolic control of adolescents with IDDM. Randomized outpatient study. Diabetes Care 1989;12(3):179–83.

    Article  PubMed  CAS  Google Scholar 

  41. Standards of medical care in diabetes – 2007. Diabetes Care 2007;30 Suppl 1:S4–S41.

    Article  CAS  Google Scholar 

  42. Weintrob N, Benzaquen H, Galatzer A, et al. Comparison of continuous subcutaneous insulin infusion and multiple daily injection regimens in children with type 1 diabetes: a randomized open crossover trial. Pediatrics 2003;112(3 Pt 1):559–64.

    Article  PubMed  Google Scholar 

  43. Burdick J, Chase HP, Slover RH, et al. Missed insulin meal boluses and elevated hemoglobin A1c levels in children receiving insulin pump therapy. Pediatrics 2004;113(3 Pt 1):e221–4.

    Article  PubMed  Google Scholar 

  44. Nutrition recommendations and principles for people with diabetes mellitus. American Diabetes Association. Tenn Med 2000;93(11):430–3.

    Google Scholar 

  45. Franz MJ. Evidence-based medical nutrition therapy for diabetes. Nutr Clin Pract 2004;19(2):137–44.

    Article  PubMed  Google Scholar 

  46. Evert A. Nutrition management tools and techniques for working with students with diabetes. School Nurse News 2005;22(1):12–6.

    PubMed  Google Scholar 

  47. Toni S, Reali MF, Barni F, Lenzi L, Festini F. Managing insulin therapy during exercise in type 1 diabetes mellitus. Acta Biomed 2006;77 Suppl 1:34–40.

    PubMed  Google Scholar 

  48. Admon G, Weinstein Y, Falk B, et al. Exercise with and without an insulin pump among children and adolescents with type 1 diabetes mellitus. Pediatrics 2005;116(3):e348–55.

    Article  PubMed  Google Scholar 

  49. Kollipara S, Warren-Boulton E. Diabetes and physical activity in school. School Nurse News 2004;21(3):12–6.

    PubMed  Google Scholar 

  50. Wilson DM, Beck RW, Tamborlane WV, et al. The accuracy of the FreeStyle Navigator continuous glucose monitoring system in children with type 1 diabetes. Diabetes Care 2007;30(1):59–64.

    Article  PubMed  CAS  Google Scholar 

  51. Buckingham B, Beck RW, Tamborlane WV, et al. Continuous glucose monitoring in children with type 1 diabetes. J Pediatr 2007;151(4):388–93, 93 e1–2.

    Article  PubMed  CAS  Google Scholar 

  52. Kaufman FR, Schantz S. Current clinical research on type 2 diabetes and its prevention in youth. School Nurse News 2007;24(3):13–6.

    PubMed  Google Scholar 

  53. Burnet D, Plaut A, Courtney R, Chin MH. A practical model for preventing type 2 diabetes in minority youth. Diabetes Educ 2002;28(5):779–95.

    Article  PubMed  Google Scholar 

  54. Boehmer TK, Brownson RC, Haire-Joshu D, Dreisinger ML. Patterns of childhood obesity prevention legislation in the United States. Prev Chronic Dis 2007;4(3):A56.

    PubMed  Google Scholar 

  55. Vail K. The medicated child. Am Sch Board J 2004;191(12):26–8.

    Google Scholar 

  56. Brener ND, Wheeler L, Wolfe LC, Vernon-Smiley M, Caldart-Olson L. Health services: results from the School Health Policies and Programs Study 2006. J Sch Health 2007;77(8):464–85.

    Article  PubMed  Google Scholar 

  57. Guttu M, Engelke MK, Swanson M. Does the school nurse-to-student ratio make a difference? J Sch Health 2004;74(1):6–9.

    Article  PubMed  Google Scholar 

  58. Healthy schools: State-level school health policies. 2007. Accessed November 26, 2007, at http://www.nasbe.org/HealthySchools/States/Topics.asp?Category$=$B&Topic$=$4.)

  59. Melton D, Henderson J. Do public schools provide optimal support for children with diabetes? Prev Chronic Dis 2007;4(3):A78.

    PubMed  Google Scholar 

  60. Lewis DW, Powers PA, Goodenough MF, Poth MA. Inadequacy of in-school support for diabetic children. Diabetes Technol Ther 2003;5(1):45–56.

    Article  PubMed  Google Scholar 

  61. Diabetes care in the school and day care setting. Diabetes Care 2007;30 Suppl 1:S66–73.

    Article  Google Scholar 

  62. Healthy schools: State level school health policies: State-by-state administration of medications. National Association of State Boards of Education. (Accessed January 7, 2008, at http://www.nasbe.org/HealthySchools/States/Topics.asp?Category$=$D&Topic$=$2.)

  63. Hellems MA, Clarke WL. Safe at school: a Virginia experience. Diabetes Care 2007;30(6):1396–8.

    Article  PubMed  Google Scholar 

  64. Diabetes care at diabetes camps. Diabetes Care 2007;30 Suppl 1:S74–6.

    Article  Google Scholar 

  65. Sawyer SM, Aroni RA. Self-management in adolescents with chronic illness. What does it mean and how can it be achieved? Med J Aust 2005;183(8):405–9.

    PubMed  Google Scholar 

  66. Amiel SA, Sherwin RS, Simonson DC, Lauritano AA, Tamborlane WV. Impaired insulin action in puberty. A contributing factor to poor glycemic control in adolescents with diabetes. N Engl J Med 1986;315(4):215–9.

    PubMed  CAS  Google Scholar 

  67. Laffel L, Pasquarello C, Lawlor MT. Treatment of the child and adolescent with diabetes. In: Kahn CR, Weir GC, King GL, Jacobsen AM, Moses AC, Smith RJ, eds. Joslin’s diabetes mellitus. 14th ed. ed. Philadelphia: Lippincott Williams & Wilkins; 2005:711–36.

    Google Scholar 

  68. Wysocki T, Taylor A, Hough BS, Linscheid TR, Yeates KO, Naglieri JA. Deviation from developmentally appropriate self-care autonomy. Association with diabetes outcomes. Diabetes Care 1996;19(2):119–25.

    Article  PubMed  CAS  Google Scholar 

  69. Bryden KS, Peveler RC, Stein A, Neil A, Mayou RA, Dunger DB. Clinical and psychological course of diabetes from adolescence to young adulthood: a longitudinal cohort study. Diabetes Care 2001;24(9):1536–40.

    Article  PubMed  CAS  Google Scholar 

  70. Martinez-Aguayo A, Araneda JC, Fernandez D, Gleisner A, Perez V, Codner E. Tobacco, alcohol, and illicit drug use in adolescents with diabetes mellitus. Pediatr Diabetes 2007;8(5):265–71.

    Article  PubMed  Google Scholar 

  71. Suris JC, Resnick MD, Cassuto N, Blum RW. Sexual behavior of adolescents with chronic disease and disability. J Adolesc Health 1996;19(2):124–31.

    Article  PubMed  CAS  Google Scholar 

  72. Charron-Prochownik D, Sereika SM, Falsetti D, et al. Knowledge, attitudes and behaviors related to sexuality and family planning in adolescent women with and without diabetes. Pediatr Diabetes 2006;7(5):267–73.

    Article  PubMed  Google Scholar 

  73. Grey M, Whittemore R, Tamborlane W. Depression in type 1 diabetes in children: natural history and correlates. J Psychosom Res 2002;53(4):907–11.

    Article  PubMed  Google Scholar 

  74. Bennett DS. Depression among children with chronic medical problems: a meta-analysis. J Pediatr Psychol 1994;19(2):149–69.

    Article  PubMed  CAS  Google Scholar 

  75. Hood KK, Huestis S, Maher A, Butler D, Volkening L, Laffel LM. Depressive symptoms in children and adolescents with type 1 diabetes: association with diabetes-specific characteristics. Diabetes Care 2006;29(6):1389–91.

    Article  PubMed  Google Scholar 

  76. Dantzer C, Swendsen J, Maurice-Tison S, Salamon R. Anxiety and depression in juvenile diabetes: a critical review. Clin Psychol Rev 2003;23(6):787–800.

    Article  PubMed  Google Scholar 

  77. Stewart SM, Rao U, Emslie GJ, Klein D, White PC. Depressive symptoms predict hospitalization for adolescents with type 1 diabetes mellitus. Pediatrics 2005;115(5):1315–9.

    Article  PubMed  Google Scholar 

  78. Garrison MM, Katon WJ, Richardson LP. The impact of psychiatric comorbidities on readmissions for diabetes in youth. Diabetes Care 2005;28(9):2150–4.

    Article  PubMed  Google Scholar 

  79. Suris JC, Parera N, Puig C. Chronic illness and emotional distress in adolescence. J Adolesc Health 1996;19(2):153–6.

    Article  PubMed  CAS  Google Scholar 

  80. Kovacs M, Goldston D, Obrosky DS, Bonar LK. Psychiatric disorders in youths with IDDM: rates and risk factors. Diabetes Care 1997;20(1):36–44.

    Article  PubMed  CAS  Google Scholar 

  81. Lawrence JM, Standiford DA, Loots B, et al. Prevalence and correlates of depressed mood among youth with diabetes: the SEARCH for Diabetes in Youth study. Pediatrics 2006;117(4):1348–58.

    Article  PubMed  Google Scholar 

  82. Liss DS, Waller DA, Kennard BD, McIntire D, Capra P, Stephens J. Psychiatric illness and family support in children and adolescents with diabetic ketoacidosis: a controlled study. J Am Acad Child Adolesc Psychiatry 1998;37(5):536–44.

    Article  PubMed  CAS  Google Scholar 

  83. Crow SJ, Keel PK, Kendall D. Eating disorders and insulin-dependent diabetes mellitus. Psychosomatics 1998;39(3):233–43.

    PubMed  CAS  Google Scholar 

  84. Jones JM, Lawson ML, Daneman D, Olmsted MP, Rodin G. Eating disorders in adolescent females with and without type 1 diabetes: cross sectional study. Bmj 2000;320(7249):1563–6.

    Article  PubMed  CAS  Google Scholar 

  85. Neumark-Sztainer D, Patterson J, Mellin A, et al. Weight control practices and disordered eating behaviors among adolescent females and males with type 1 diabetes: associations with sociodemographics, weight concerns, familial factors, and metabolic outcomes. Diabetes Care 2002;25(8):1289–96.

    Article  PubMed  Google Scholar 

  86. Meltzer LJ, Johnson SB, Prine JM, Banks RA, Desrosiers PM, Silverstein JH. Disordered eating, body mass, and glycemic control in adolescents with type 1 diabetes. Diabetes Care 2001;24(4):678–82.

    Article  PubMed  CAS  Google Scholar 

  87. Rydall AC, Rodin GM, Olmsted MP, Devenyi RG, Daneman D. Disordered eating behavior and microvascular complications in young women with insulin-dependent diabetes mellitus. N Engl J Med 1997;336(26):1849–54.

    Article  PubMed  CAS  Google Scholar 

  88. Nielsen S. Eating disorders in females with type 1 diabetes: An update of a meta-analysis. Eur Eat Disord Rev 2002;10(4):241–54.

    Article  Google Scholar 

  89. Steel JM, Young RJ, Lloyd GG, Clarke BF. Clinically apparent eating disorders in young diabetic women: associations with painful neuropathy and other complications. Br Med J (Clin Res Ed) 1987;294(6576):859–62.

    Article  CAS  Google Scholar 

  90. Lernmark B, Persson B, Fisher L, Rydelius PA. Symptoms of depression are important to psychological adaptation and metabolic control in children with diabetes mellitus. Diabet Med 1999;16(1):14–22.

    Article  PubMed  CAS  Google Scholar 

  91. Whittemore R, Kanner S, Singleton S, Hamrin V, Chiu J, Grey M. Correlates of depressive symptoms in adolescents with type 1 diabetes. Pediatr Diabetes 2002;3(3):135–43.

    Article  PubMed  Google Scholar 

  92. Nakazato M, Kodama K, Miyamoto S, Sato M, Sato T. Psychiatric disorders in juvenile patients with insulin-dependent diabetes mellitus. Diabetes Res Clin Pract 2000;48(3):177–83.

    Article  PubMed  CAS  Google Scholar 

  93. Anderson BJ, Wolpert HA. A developmental perspective on the challenges of diabetes education and care during the young adult period. Patient Educ Couns 2004;53(3):347–52.

    Article  PubMed  Google Scholar 

  94. Ramchandani N, Cantey-Kiser JM, Alter CA, et al. Self-reported factors that affect glycemic control in college students with type 1 diabetes. Diabetes Educ 2000;26(4):656–66.

    Article  PubMed  CAS  Google Scholar 

  95. Wdowik MJ, Kendall PA, Harris MA. College students with diabetes: using focus groups and interviews to determine psychosocial issues and barriers to control. Diabetes Educ 1997;23(5):558–62.

    Article  PubMed  CAS  Google Scholar 

  96. Mellinger DC. Preparing students with diabetes for life at college. Diabetes Care 2003;26(9):2675–8.

    Article  PubMed  Google Scholar 

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Smaldone, A., Lawlor, M.T. (2009). Pediatric Diabetes Education: A Family Affair. In: Weinger, K., Carver, C.A. (eds) Educating Your Patient with Diabetes. Contemporary Diabetes. Humana Press. https://doi.org/10.1007/978-1-60327-208-7_16

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  • DOI: https://doi.org/10.1007/978-1-60327-208-7_16

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