When you have a child with diabetes, you and your family have a
lot to learn, but you don't have to go it alone. Your
child's diabetes health care team can help.
Treating diabetes requires the expertise of many types of health
care providers, such as doctors, certified diabetes educators,
dietitians, and mental health professionals.
What the Health Care Team Does
The diabetes health care team teaches families all about
diabetes. It helps families create and use the child's
treatment plan, also called the diabetes management plan.
The team adjusts
insulin
and other diabetes medications, develops
meal plans
, and makes
physical activity
recommendations to help control blood sugar levels.
All team members should take into account your child's
schedule, skills, preferences, lifestyle, and growth and
developmental needs. The team will also help you cope with the
parenting challenges of having a child with a chronic illness and
will help your child cope with his or her own set of
challenges.
Keep in mind that you and your child are the captains of your
diabetes health care team - all of the team activities center
around helping you and your child manage diabetes. In many cases,
the roles and responsibilities of the team members overlap. You
should feel comfortable communicating with all of the team members
because you'll be in contact with them often.
Doctors
A pediatric endocrinologist is a doctor who specializes in the
diagnosis and treatment of children with diseases of the
endocrine system
, such as diabetes and
growth disorders
. But pediatricians, family practitioners, and other medical
doctors also can treat kids with diabetes and manage their health
care needs.
It's important to recognize that seeing a specialist like a
pediatric endocrinologist doesn't replace the need for your
child to continue to get general health care from a pediatrician or
other primary care doctor.
You and your child should feel comfortable with the doctors you
choose because your child's diabetes management plan is based
on the doctor's prescribed treatment. Ask plenty of questions
and make sure you understand the answers.
Doctors will ask detailed questions about how your child is
feeling and will perform physical examinations. They will also
teach you and your child about diabetes and incorporate the
recommendations of all the team members into a comprehensive
diabetes management plan.
The doctor will lead the other members of the diabetes team in
developing an individualized plan for managing diabetes. In
addition to monitoring your child for diabetes complications and
other medical conditions associated with diabetes, the doctor also
will make changes to insulin schedules and write prescriptions for
medications and referrals to other specialists as needed.
Certified Diabetes Educators (CDEs)
Certified diabetes educators (CDEs) are nurses, dietitians,
social workers, doctors, or pharmacists who help people manage
their diabetes. CDEs have had special training to teach parents and
kids.
CDEs will:
- explain what diabetes is and how it affects the body
- teach you and your child how to give insulin injections or
use an insulin pump
- explain how to treat high and low blood sugar levels
- show you how to adjust medications for exercise and sick
days
- demonstrate how to test blood sugar levels, work the
blood glucose meter
, and test the accuracy of blood sugar monitoring equipment used
in the home
- review the diabetes management goals with you
- discuss any challenges you and your child may be facing
Dietitians
Registered dietitians are experts in nutrition and meal
planning. They know about food composition and its effects on the
body and blood sugar levels. Just as your child grows and develops,
so must his or her meal plan, which you can discuss with the
dietitian.
Expect the dietitian to track your child's growth and
recommend the appropriate amount of calories required each day. The
dietitian also will:
- make adjustments to meal plans based on sports, holidays,
special events, and other activities
- provide
snack and recipe ideas
- teach you and your child how to make healthy food
choices
- help you and your child learn carbohydrate counting and meal
planning techniques
- teach you to read
food labels
and develop strategies for determining the carbohydrate content
of foods when food labels aren't available
Mental Health Professionals
A mental health professional, usually a social worker or
psychologist (but sometimes a psychiatrist or counselor), can be an
invaluable resource to families dealing with diabetes, which can be
overwhelming.
Mental health professionals can help parents assess any troubles
or problems occurring at home, work, or school. They can also
monitor how diabetes care is affecting the entire family. In
addition, they can help you determine strategies to improve your
child's diabetes management.
Social workers also direct you to outside resources (like
support groups) that help families with diabetes. They can also
suggest ways that families can get necessary diabetes equipment and
supplies and help families deal with insurance and financial
issues.
Psychologists and psychiatrists can use behavior modification
techniques to help kids if they're having difficulty
controlling their diabetes, dealing with anger or sadness, or
having difficulty taking on the responsibility of caring for their
own diabetes as they mature. Psychiatrists can also prescribe
medications for emotional problems related to diabetes, such as
depression
.
Depending on where you live and the type of diabetes facility
that you visit (whether it's a specialty diabetes clinic or
pediatrician's office), you may find all members of your team
in one place. Or you might visit several different offices for
diabetes care. If you don't have access to a dietitian or
mental health professional but would like to see one, ask the
doctor to refer you to one.
Every person on the team is important to managing your
child's diabetes, so make sure all of them know the plan so
care is as well coordinated as possible.
Reviewed by:
Steven Dowshen, MD
Date reviewed: September 2008
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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