Female, 25 years of age related a story to me she recalls from years back.
Patient was diagnosed with type 1 diabetes at 5 years of age. Mother has had type 1 diabetes since childhood, so patient had learned a lot about living with type 1 diabetes since a young child. Patient is and has been a very independent person. Both her mother and father trusted her and for the most part worked with her pediatrician to manage her diabetes.
At 13 years of age, patient developed pneumonia. She was coughing a lot, and was not able to eat as she usually does. She was not checking her glucose on a more regular basis due to her illness. “I was too sick and I did not know. And, we did not have CGM at that time.”
Next thing she remembered, she woke up in the hospital. She was admitted due to DKA with a glucose of 936. She was hospitalized, treated and released. She and family resumed her normal care except she now says, “I shouldn’t have been totally relied upon and I know now.”
- Although it’s important to teach parents and children who have type 1 diabetes about their diabetes, children still need adult intervention. As the patient says, teaching independence is good, but not too much.
- Discuss, teach, and practice transition care at different ages and stages.
- As part of diabetes education, always teach sick day management.
- For people who have type 1 diabetes, always recommend insulin and CGM.
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