Abstract
Type 1 diabetes mellitus is a common chronic medical disorder of childhood and adolescence that requires intensive day to day management. In addition to measuring dietary intake, children and adolescents with diabetes must test their blood sugar and administer insulin multiple times daily. They are also responsible for correcting high and low sugars. A comprehensive diabetes knowledge base and effective family communication and problem solving skills are necessary to optimize blood sugar control, so as to avoid both short- and long-term diabetes complications. Diabetes management requires a unique therapeutic alliance in which patients and their families manage diabetes, and their healthcare providers serve as mentors and consultants.
Although diabetes-related stresses in themselves can be overwhelming, these stresses are often complicated by patient-related psychosocial stressors such as anxiety, an eating disorder, or depression. In addition, family and larger system challenges such as marital discord and the presence of other family chronic disease or financial pressures may also interfere with optimal diabetes management. This can result in adherence issues, functional symptoms, or suboptimal diabetes control. To complicate matters further, psychosocial issues often can lead to suboptimal blood sugar control, which in itself, can cause psychosocial distress.
Since blood sugar control and psychosocial factors are so closely linked, it is imperative that a whole person approach be followed for optimal diabetes management. Diabetes issues, especially those related to regimen adherence, need to be evaluated from a psychosocial as well as medical perspective and interdisciplinary solutions should be offered. In addition, research suggests that successful diabetes management requires a collaborative approach by medical and mental health professionals familiar with type 1 diabetes and its treatment.
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This work was supported in part, by grants from BD and the HAPI Foundation.
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Pilek, N.L., Starkman, H.S. (2014). Functional and Psychosocial Ramifications of Type 1 Diabetes Mellitus in Pediatric Endocrinology. In: Anbar, R. (eds) Functional Symptoms in Pediatric Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4899-8074-8_9
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DOI: https://doi.org/10.1007/978-1-4899-8074-8_9
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