Emotional support

Learning that your child has diabetes is a traumatic event for any family. Adapting to and managing diabetes upsets the normal routine at home and can place a strain on family relationships.

Diabetes can be fitted into an active and healthy life, and a settled home life, but you need help and support to do this. There may be some emotional or behavioural problems that you are finding difficult to manage on your own; perhaps your child is refusing to do blood tests, is worried about being bullied at school, or anxious about changing to an adult diabetes care team.

This is why diabetes care should also include input from a psychologist and/or counsellor if needed. Don’t be afraid to ask your diabetes care team for help in this area.

Diabetes at school – including pre-school facilities

It is important that there is good communication between your child’s school staff and the diabetes care team. In most instances the diabetes specialist nurse will visit the school to talk to your child’s teacher and other staff about diabetes. S/he can explain about hypos, your child’s meal and snack times, exercise and who to contact in an emergency.

Medical checks

Children with diabetes should have a complete medical check by the diabetes care team. This may take the form of a yearly review or it may take place at each visit.

These checks will show how your child is managing with injections, diet and diabetes control. They also allow the team to check for any signs of diabetes ‘complications’, which can affect the feet, eyes, kidneys and circulation.

Complications are rare in children, and we know that good diabetes control greatly reduces the risk. However, it is sensible for your child to have regular checks (at least once a year) so that any problems can be picked up early and treated.

The check

The check should include:

·        blood test

·        urine test

·        blood pressure check

·        injection sites check

·        foot examination

·        diet review

·        weight and height check

·        eye examination (from the age of 12 onwards)

·        discussion of any worries you may have, and setting realistic targets for control and management for the coming year.

Making the most of your appointment

Communicating with healthcare professionals is not always easy. Here are some points to help you make the most of your time.

Before

·        decide what you want to get from the visit

·        make a list of the points you want to raise

·        inform yourself – if you know more about the things that are concerning you, you’ll be in a better position to ask questions

·        find out about how much time you will have.

During

·        confirm how much time you’ll have – and ask for more if you need it

·        use your list to check that you have covered all the points you wanted to raise

·        make notes to refer to later

·        ask for clarification if you’re unsure about what is being said. You could say ‘Can I check what you meant is…’

·        try and listen actively, asking questions and giving feedback

·        ask for more time to think about an answer if you need to.

After

·        review what you think has been agreed and achieved

·        make a note of anything you need to do before your next appointment

·        make a date for the next appointment.

Changing to an adult clinic

As your child gets older, the diabetes care team will be trying to encourage him/her to take on some more responsibility for doing his/her own injections and blood tests and keeping a record of his/her test results.

In this way, your child will start to understand how food, exercise and insulin affects their diabetes, and how to make adjustments to ‘keep in control.’

When your child reaches the mid teenage years (generally 16 or over) s/he will probably come under the care of a new diabetes care team, specialising in adults with diabetes. Exactly when this happens depends on the individual child and the facilities available in your area.

Your child will have got used to their children’s team and perhaps made friends with other children attending, but the children’s team and the adult team should work together to make sure the transfer is as smooth as possible.