Shared Medical Appointments for Adolescents With Type 1 Diabetes Mellitus: Important Learning Communities

Abstract

The Pediatric Endocrinology Nursing Society (PENS) is committed to the development and advancement of nurses in the art and science of pediatric Type 1 diabetes mellitus (T1DM) results from autoimmune destruction of the insulin-producing pancreatic beta cells, leading to an absolute insulin deficiency state. The impact of the diagnosis on children, parents, and other family members can be overwhelming. Diabetes education is a labor-intensive process to empower parents, and eventually adolescents, to be primary care managers. Parenting a child with diabetes involves a delicate balance between ensuring that the child is medically safe and encouraging the child to assume a developmentally appropriate level of independence. At each stage of growth and development, children experience different challenges, and suboptimal glycemic control is often noted in the struggle to achieve a balance between carbohydrate intake, exercise and insulin requirements (Lowes et al., 2014). Adolescents generally have poorer glycemic control than other age groups. Effectively managing their diabetes and the impact on their daily activities requires knowledge, skills, and an appropriate attitude toward self-care (Graue, Wentzel-Larsen, Hanestad, & Sovik, 2005). In addition to monitoring blood glucose (BG) levels, counting carbohydrates, and adjusting insulin based on activities, adolescents must react appropriately to glucose levels and trends. Shifting away from the traditional visits and didactic education to an interactive practice provides psychosocial and behavioral support (Eisenstat, Ulman, Siegel, & Carlson, 2012) and is relevant to youth with other chronic disorders.