Identify The Lifestyle Changes For Both The Patient And Potentially The Family For Juvenile Diabetes

Type 1 Diabetes

Print Diagnosis Diagnostic tests include: Glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to the oxygen-carrying protein in red blood cells (hemoglobin). The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. An A1C level of 6.5 percent or higher on two separate tests indicates diabetes. If the A1C test isn't available, or if you have certain conditions that can make the A1C test inaccurate — such as pregnancy or an uncommon form of hemoglobin (hemoglobin variant) — your doctor may use these tests: Random blood sugar test. A blood sample will be taken at a random time and may be confirmed by repeat testing. Blood sugar values are expressed in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). Regardless of when you last ate, a random blood sugar level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes, especially when coupled with any of the signs and symptoms of diabetes, such as frequent urination and extreme thirst. Fasting blood sugar test. A blood sample will be taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it's 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes. If you're diagnosed with diabetes, your doctor may also run blood tests to check for autoantibodies that are common in type 1 diabetes. These tests help your doctor distinguish between type 1 and type 2 diabetes when the diagnosis is uncertain. The presence of ketones — byproducts from the breakdown of fat — in your urine also suggests type 1 diab Continue reading >>

Care Of Children And Adolescents With Type 1 Diabetes

A statement of the American Diabetes Association ADA, American Diabetes Association AER, albumin excretion rate CVD, cardiovascular disease DCCT, Diabetes Control and Complications Trial DKA, diabetic ketoacidosis EDIC, Epidemiology of Diabetes Interventions and Complications EMA, endomysial autoantibody MDI, multiple daily insulin injection NCEP, National Cholesterol Education Program NCEP-Peds, National Cholesterol Education Program for Pediatrics SMBG, self-monitoring of blood glucose tTG, tissue transglutaminase During recent years, the American Diabetes Association (ADA) has published detailed guidelines and recommendations for the management of diabetes in the form of technical reviews, position statements, and consensus statements. Recommendations regarding children and adolescents have generally been included as only a minor portion of these documents. For example, the most recent ADA position statement on “Standards of Medical Care for Patients With Diabetes Mellitus” (last revised October 2003) included “special considerations” for children and adolescents (1). Other position statements included age-specific recommendations for screening for nephropathy (2) and retinopathy (3) in children with diabetes. In addition, the ADA has published guidelines pertaining to certain aspects of diabetes that apply exclusively to children and adolescents, including care of children with diabetes at school (4) and camp (5) and a consensus statement on type 2 diabetes in children and adolescents (6). The purpose of this document is to provide a single resource on current standards of care pertaining specifically to children and adolescents with type 1 diabetes. It is not meant to be an exhaustive compendium on all aspects of the management of pediatric diabetes. Howeve Continue reading >>

Tight Control Of Type 1 Diabetes: Recommendations For Patients

STEPHEN HAVAS, M.D., M.P.H., M.S., American Medical Association, Chicago, Illinois THOMAS DONNER, M.D., University of Maryland School of Medicine, Baltimore, Maryland Am Fam Physician. 2006 Sep 15;74(6):971-978. Patient information: See related handout on type 1 diabetes, written by the authors of this article. Tight control of blood glucose levels and risk factors for cardiovascular disease (e.g., hypertension, hypercholesterolemia) can substantially reduce the incidence of microvascular and macrovascular complications from type 1 diabetes. Physicians play an important role in helping patients make essential lifestyle changes to reduce the risk of these complications. Key recommendations that family physicians can give patients to optimize their outcomes include: take control of daily decisions regarding your health, focus on preventing and controlling risk factors for cardiovascular disease, tightly control your blood glucose level, be cognizant of potentially inaccurate blood glucose test results, use physiologic insulin replacement regimens, and learn how to manage and prevent hypoglycemia. Randomized clinical trials1–5 have demonstrated that tight control of blood glucose levels reduces the risk of microvascular and macrovascular complications in patients with type 1 diabetes; this is not true for patients with type 2 diabetes. Although many patients with type 1 diabetes may benefit from tightly controlling their blood glucose levels,3 few do so.6 The Diabetes Control and Complications Trial (DCCT)4 showed that, compared with conventional therapy, intensive therapy significantly reduced the risk of retinopathy progression (4.7 versus 1.2 per 100 patient-years, number needed to treat [NNT] = three for 10 years) and clinical neuropathy (9.8 versus 3.1 per 100 patie Continue reading >>

Developmental Changes In The Roles Of Patients And Families In Type 1 Diabetes Management

Developmental Changes in the Roles of Patients and Families in Type 1 Diabetes Management Katharine C. Garvey , MD, MPH, and Lori M.B. Laffel , MD, MPH Jessica T. Markowitz, Pediatric, Adolescent, & Youth Adult Section, Joslin Diabetes Center, Boston, MA, 617-309-4723 (p); 617-309-2451 (f) The publisher's final edited version of this article is available at Curr Diabetes Rev See other articles in PMC that cite the published article. Developmentally-tailored diabetes self-care education and support are integral parts of contemporary multidisciplinary T1D care. The patient with T1D must have the support of the family and the diabetes team to maintain the rigors of diabetes management, but the specific roles of patients and families with regard to daily diabetes tasks change considerably throughout the developmental span of early childhood, middle childhood/school-age years, and adolescence. This review provides a framework of key normative developmental issues for each of these developmental stages. Within this context, ideal family diabetes management is reviewed within each developmental stage and anticipated challenges that can arise during these stages and that can adversely impact diabetes management are presented. This paper also summarizes empiric evidence for specific intervention and care strategies to support optimal diabetes management across these stages in order to maximize opportunities for a successful transfer of diabetes management tasks from parents to maturing youth. Finally, the review provides an emphasis on approaches to promote family teamwork and adolescent diabetes self-care adherence as well as opportunities to use novel technology platforms as a means to support optimal diabetes management. Keywords: Type 1 diabetes, pediatrics, intensive thera Continue reading >>

Management Strategies For The Adolescent Lifestyle

Management Strategies for the Adolescent Lifestyle Barb Schreiner, RN, MN, CDE, Shannon Brow, RN, BSN, CDE, and Typical adolescent lifestyle issues pose many challenges that are further complicated when teens have diabetes. This article presents four teens, each with different lifestyle considerations, and creative diabetes management approaches to address their needs. How much more complicated can life be than for adolescents with diabetes? The demands of diabetes often pull teens in different directions as they struggle through the normal developmental challenges of the age. For teens, it is typical to feel self-conscious about personal appearance. Yet diabetes demands visible ID tags. It is normal for teens to practice becoming independent. Yet diabetes demands a degree of dependence on parents and health care professionals. And it is common for teens to stay grounded in the present. Yet diabetes and its potential long-term complications serve as a constant reminder of an uncertain future. Table 1. The Impact of Diabetes on Adolescents 11-14 Years Old provide diabetes education about the standards of care Marta, age 16, has had type 1 diabetes for 7 years. Her weekly schedule includes school club meetings, work as the school yearbook editor, weekend dates, and volunteer activities. She has few meals at home and is usually with friends from morning until night. In her list of priorities, diabetes care frequently falls well below her social plans. Marta needs a flexible but effective and safe management approach. An intensified insulin program might be ideal for Marta. With such a program, teens have much more latitude with meal timing and amounts of food consumed. An intensive insulin program using long-acting and rapid-acting insulins affords flexibility in schedule Continue reading >>

Type 1 Diabetes In Children And Adolescents

Chapter Headings Introduction Hypoglycemia Immunization Key Messages Suspicion of diabetes in a child should lead to immediate confirmation of the diagnosis and initiation of treatment to reduce the likelihood of diabetic ketoacidosis (DKA). Management of pediatric DKA differs from DKA in adults because of the increased risk for cerebral edema. Pediatric protocols should be used. Children should be referred for diabetes education, ongoing care and psychosocial support to a diabetes team with pediatric expertise. Note: Unless otherwise specified, the term “child” or “children” is used for individuals 0 to 18 years of age, and the term “adolescent” for those 13 to 18 years of age. Introduction Diabetes mellitus is the most common endocrine disease and one of the most common chronic conditions in children. Type 2 diabetes and other types of diabetes, including genetic defects of beta cell function, such as maturity-onset diabetes of the young, are being increasingly recognized in children and should be considered when clinical presentation is atypical for type 1 diabetes. This section addresses those areas of type 1 diabetes management that are specific to children. Education Children with new-onset type 1 diabetes and their families require intensive diabetes education by an interdisciplinary pediatric diabetes healthcare (DHC) team to provide them with the necessary skills and knowledge to manage this disease. The complex physical, developmental and emotional needs of children and their families necessitate specialized care to ensure the best long-term outcomes (1,2). Education topics must include insulin action and administration, dosage adjustment, blood glucose (BG) and ketone testing, sick-day management and prevention of diabetic ketoacidosis (DKA), nutr Continue reading >>

Treating Type 1 Diabetes

en espaolEl tratamiento de la diabetes tipo 1 If your child or teen has been diagnosed with type 1 diabetes , the next step is to create a diabetes management plan to help him or her manage the condition and stay healthy and active. Treatment plans for type 1 diabetes are based on each child's needs and the suggestions of the diabetes health care team . Treatment approaches differ in, among other things, the types of insulin given and the schedules for giving insulin given each day. The advantages and disadvantages of a plan should be considered for each child. The blood glucose level is the amount of glucose in the blood. Glucose is the main source of energy for the body's cells and is carried to each cell through the bloodstream. The hormone insulin allows the glucose to get into the cells. In type 1 diabetes, the body can no longer make insulin, so the glucose can't get into the body's cells. This makes the blood glucose level rise. Treatment goals for kids with diabetes are to control the condition in a way that minimizes symptoms; prevents short- and long-term health problems; and helps them to have normal physical, mental, emotional, and social growth and development. To do this, parents and kids should aim for the goal of keeping blood sugar levels as close to normal as possible. In general, kids with type 1 diabetes need to: eat a healthy, balanced diet, paying special attention to the amount of carbohydrates in each meal and the diabetes meal plan check blood sugar levels several times a day Following the treatment plan helps kids stay healthy, but treating diabetes isn't the same as curing it. Right now, there's no cure for diabetes, so kids with type 1 diabetes will need treatment for the rest of their lives. But with proper care, they should look and feel h Continue reading >>

Type 1 Diabetes

Type 1 diabetes (insulin dependent diabetes, juvenile) is a condition in which the body stops making insulin. This causes the person's blood sugar to increase. There are two types of diabetes, type 1 and type 2. In type 1 diabetes, the pancreas is attacked by the immune system and then it cannot produce insulin. In type 2 diabetes the pancreas can produce insulin, but the body can't use it. Causes of type 1 diabetes are auto-immune destruction of the pancreatic beta cells. This can be caused by viruses and infections as well as other risk factors. In many cases, the cause is not known. Scientists are looking for cures for type 1 diabetes such as replacing the pancreas or some of its cells. Risk factors for type 1 diabetes are family history, introducing certain foods too soon (fruit) or too late (oats/rice) to babies, and exposure to toxins. Symptoms of type 1 diabetes are skin infections, bladder or vaginal infections, and Sometimes, there are no significant symptoms. Type 1 diabetes is diagnosed by blood tests. The level of blood sugar is measured, and then levels of insulin and antibodies can be measured to confirm type 1 vs. type 2 diabetes. Type 1 diabetes is treated with insulin and lifestyle changes. Specifically, meal planning to ensure carbohydrate intake matches insulin dosing. Complications of type 1 diabetes are kidney disease, eye problems, heart disease, and nerve problems (diabetic neuropathy) such as loss of feeling in the feet. Poor wound healing can also be a complication of type 1 diabetes. Type 1 diabetes cannot be prevented, however, keeping blood sugar at healthy levels may delay or prevent symptoms or complications. There is currently no cure, and most cases of type 1 diabetes have no known cause. The prognosis or life-expectancy for a person with Continue reading >>

Diabetes - Issues For Children And Teenagers

On this page: Diabetes mellitus (diabetes) is a chronic and potentially life-threatening condition characterised by the body losing its ability to produce insulin or beginning to produce or use insulin less efficiently. People living with type 1 diabetes must inject insulin regularly, as must some people with type 2 diabetes. Many people with type 2 diabetes can manage their condition with careful diet, exercise and regular testing. Until recently almost all children and teenagers with diabetes had type 1, but now younger people are getting type 2 diabetes due to increasing rates of obesity and being overweight. Children or teenagers who have recently been diagnosed with diabetes may struggle with their emotional reactions to their condition and the reactions of others, and have concerns about going back to school. Teenagers with diabetes may also worry about things like negotiating sex, drinking alcohol, smoking and illicit drugs. A child and their family will need a period of adjustment after diabetes is diagnosed. They must establish a routine for blood glucose monitoring and injecting, learn how to count carbohydrates, see diabetes health professionals regularly and cope with fluctuating blood glucose levels. New challenges may arise as a child moves through different life stages. Reactions to a diagnosis of diabetes A child or teenager newly diagnosed with diabetes will have a range of reactions and emotions. Common reactions experienced by children and their parents include shock, denial, anger, sadness, fear and guilt. These feelings usually subside with time and appropriate support. Common responses to a diagnosis of diabetes include: anxiety about the condition fear of needles and multiple injections a feeling of being overwhelmed by injecting and other tasks t Continue reading >>

Diabetes Management

The term diabetes includes several different metabolic disorders that all, if left untreated, result in abnormally high concentration of a sugar called glucose in the blood. Diabetes mellitus type 1 results when the pancreas no longer produces significant amounts of the hormone insulin, usually owing to the autoimmune destruction of the insulin-producing beta cells of the pancreas. Diabetes mellitus type 2, in contrast, is now thought to result from autoimmune attacks on the pancreas and/or insulin resistance. The pancreas of a person with type 2 diabetes may be producing normal or even abnormally large amounts of insulin. Other forms of diabetes mellitus, such as the various forms of maturity onset diabetes of the young, may represent some combination of insufficient insulin production and insulin resistance. Some degree of insulin resistance may also be present in a person with type 1 diabetes. The main goal of diabetes management is, as far as possible, to restore carbohydrate metabolism to a normal state. To achieve this goal, individuals with an absolute deficiency of insulin require insulin replacement therapy, which is given through injections or an insulin pump. Insulin resistance, in contrast, can be corrected by dietary modifications and exercise. Other goals of diabetes management are to prevent or treat the many complications that can result from the disease itself and from its treatment. Overview[edit] Goals[edit] The treatment goals are related to effective control of blood glucose, blood pressure and lipids, to minimize the risk of long-term consequences associated with diabetes. They are suggested in clinical practice guidelines released by various national and international diabetes agencies. The targets are: HbA1c of 6%[1] to 7.0%[2] Preprandial blood Continue reading >>

Diabetes (children And Adults)

Children and Adolescents, Health Care and Illness PRINTED FROM the Encyclopedia of Social Work, accessed online. (c) National Association of Social Workers and Oxford University Press USA, 2016. All Rights Reserved. Under the terms of the applicable license agreement governing use of the Encyclopedia of Social Work accessed online, an authorized individual user may print out a PDF of a single article for personal use, only (for details see Privacy Policy ). The purpose of this article is to provide an overview of: diabetes and its significance, the differences in types of diabetes, and landmark clinical trials that have resulted in changes in philosophy and treatment of diabetes. Second, a review of the various types of evidence-based and promising behavioral interventions in the literature that have targeted children and adults are presented. Social workers and other helping professionals are uniquely positioned to work collaboratively to improve psychosocial functioning, disease management, and prevent or delay complications through behavioral interventions for children and adults with diabetes. Keywords: children with diabetes , adults with diabetes , behavioral interventions , diabetes self-management , self-management education , family systems therapy , motivational interviewing , diabetes clinical trials , diabetes health disparities , cognitive behavioral therapy Diabetes mellitus is a disease that is characterized by high levels of blood glucose resulting from problems with the production of insulin from the pancreas or failure to use the insulin properly (Centers for Disease Control and Prevention [CDC], 2011 ). Insulin moves glucose (dietary sugar) from the bloodstream into cells for energy or storage. Without insulin, glucose remains in the blood, causing h Continue reading >>

Diabetes (mellitus, Type 1 And Type 2)

A A A Are There Home Remedies (Diet, Exercise, and Glucose Monitoring) for Diabetes? Diabetes is a condition characterized by the body's inability to regulate glucose (sugar) levels in blood. In type 1 diabetes, the body does not produce enough insulin. People with type 2 diabetes can produce insulin, but the body is not able to use the insulin effectively. The cause of type 1 diabetes is an autoimmune reaction. Combinations of genetic risk factors and unhealthy lifestyle choices cause type 2 diabetes. The main diagnostic test for diabetes is measurement of the blood glucose level. Changes in lifestyle and diet may be adequate to control some cases of type 2 diabetes. Others with type 2 diabetes require medications. Insulin is essential treatment for type 1 diabetes. No effective approach yet exists to prevent type 1 diabetes. Prevention of type 2 diabetes can be accomplished in some cases by maintaining a healthy weight, exercising, sustaining a healthy lifestyle. Prediabetes is a condition that can occur before development of type 2 diabetes. Complications of any type of diabetes include damage to blood vessels, leading to heart disease or kidney disease. Damage to blood vessels in the eye can result in vision problems including blindness. Nerve damage can occur, leading to diabetic neuropathy. Diabetes mellitus (DM) is a set of related diseases in which the body cannot regulate the amount of sugar (specifically, glucose) in the blood. The blood delivers glucose to provide the body with energy to perform all daily activities. The liver converts the food a person eats into glucose. The glucose is then released into the bloodstream from the liver between meals. In a healthy person, several hormones tightly regulate the blood glucose level, primarily insulin. Insulin is Continue reading >>

Diabetes Management In Young People Family Matters

Diabetes Management In Young People Family Matters High levels of family involvement and support contribute to successful management of a rigorous diabetes regimen. Diabetes imposes significant lifelong demands on patients intent on maintaining both glycemic control and quality of life. Consistent family support plays an integral part in adherence to an effective disease management regimen whether children, adolescents, or adults face the challenges that diabetes presents. The prevalence of diabetes in the United States continues to increase for all ages, according to the American Diabetes Association. In 2007, 23.6 million children and adults, or 8% of the nations population, had diabetes. Last year alone, 1.6 million new cases of diabetes were diagnosed in people aged 20 or older. Among those under the age of 20, 186,000, or 0.22% of those in this age group, have diabetes. Regardless of age, persons with diabetes face issues related to intensive disease management, lifestyle modifications, potential complications, and psychological adjustment. A study published in the October 2005 issue of Diabetic Medicine examined the emotional concerns and self-management behaviors of 5,104 adults with type 1 and type 2 diabetes from 13 countries, including the United States. Researchers discovered that the majority of patients in nearly all countries believed they were unsuccessful with their diabetes management. With the dramatic increase in type 2 diabetes among children and adolescents, researchers are identifying and examining psychosocial barriers to type 2 diabetes management among young persons in an attempt to reduce the risk of associated complications. The first study of its kind, conducted by Wendy Auslander, PhD, a professor of social work at Washington Universitys Ge Continue reading >>

Pediatric Type 1 Diabetes Mellitus

Author: William H Lamb, MD, MBBS, FRCP(Edin), FRCP, FRCPCH; Chief Editor: Sasigarn A Bowden, MD more... Type 1 diabetes is a chronic illness characterized by the bodys inability to produce insulin due to the autoimmune destruction of the beta cells in the pancreas. Most pediatric patients with diabetes have type 1 and a lifetime dependence on exogenous insulin. [ 1 ] The image below depicts the effects of insulin deficiency. Signs and symptoms of type 1 diabetes in children include the following: See Clinical Presentation for more detail. Blood glucose tests using capillary blood samples, reagent sticks, and blood glucose meters are the usual methods for monitoring day-to-day diabetes control. Diagnostic criteria by the American Diabetes Association (ADA) include the following [ 2 ] : A fasting plasma glucose (FPG) level 126 mg/dL (7.0 mmol/L), or A 2-hour plasma glucose level 200 mg/dL (11.1 mmol/L) during a 75-g oral glucose tolerance test (OGTT), or A random plasma glucose 200 mg/dL (11.1 mmol/L) in a patient with classic symptoms of hyperglycemia or hyperglycemic crisis Measurement of HbA1c levels is the best method for medium-term to long-term diabetic control monitoring. An international expert committee composed of appointed representatives of the American Diabetes Association, the European Association for the Study of Diabetes, and others recommended HbA1c assay for diagnosing diabetes mellitus. [ 3 ] The ADA recommends using patient age as one consideration in the establishment of glycemic goals, with different targets for preprandial, bedtime/overnight, and hemoglobin A1c (HbA1c) levels in patients aged 0-6, 6-12, and 13-19 years. [ 4 ] Benefits of tight glycemic control include not only continued reductions in the rates of microvascular complications but als Continue reading >>

6 Lifestyle Changes To Control Your Diabetes

Working closely with your doctor, you can manage your diabetes by focusing on six key changes in your daily life. 1. Eat healthy. This is crucial when you have diabetes, because what you eat affects your blood sugar. No foods are strictly off-limits. Focus on eating only as much as your body needs. Get plenty of vegetables, fruits, and whole grains. Choose nonfat dairy and lean meats. Limit foods that are high in sugar and fat. Remember that carbohydrates turn into sugar, so watch your carb intake. Try to keep it about the same from meal to meal. This is even more important if you take insulin or drugs to control your blood sugars. 2. Exercise. If you're not active now, it’s time to start. You don't have to join a gym and do cross-training. Just walk, ride a bike, or play active video games. Your goal should be 30 minutes of activity that makes you sweat and breathe a little harder most days of the week. An active lifestyle helps you control your diabetes by bringing down your blood sugar. It also lowers your chances of getting heart disease. Plus, it can help you lose extra pounds and ease stress. 3. Get checkups. See your doctor at least twice a year. Diabetes raises your odds of heart disease. So learn your numbers: cholesterol, blood pressure, and A1c (average blood sugar over 3 months). Get a full eye exam every year. Visit a foot doctor to check for problems like foot ulcers and nerve damage. 4. Manage stress. When you're stressed, your blood sugar levels go up. And when you're anxious, you may not manage your diabetes well. You may forget to exercise, eat right, or take your medicines. Find ways to relieve stress -- through deep breathing, yoga, or hobbies that relax you. 5. Stop smoking. Diabetes makes you more likely to have health problems like heart disease Continue reading >>