Diabetes and Puberty – How Nurses Can Help Teens and Their Parents Manage Blood Glucose

Trenton Jantzi replaces his insulin pump infusion site during a break at school. The high-school senior must change his infusion site every three days. Photo by Mark Ylen / Democrat-Herald. Trenton Jantzi replaces his insulin pump infusion site during a break at school. The high-school senior must change his infusion site every three days. Photo by Mark Ylen / Democrat-Herald.

A new article in AJN gives crucial information on the challenges to managing diabetes, both type 1 and type 2, that are faced by teenagers and their parents during the physical and psychosocial changes of puberty.

Any nurse can tell you that it’s not easy to manage diabetes. I got type 1 diabetes when I was 27 years old and it took me more than ten years to really understand how to balance the effects of diet, exercise, insulin intake, and other factors like illness or stress.

There’s a lot at stake, too, in terms of long-term complications linked to poor blood glucose control, including blindness, heart disease, neuropathy, and a host of other unpleasant complications. In addition, there are serious potential short-term risks of diabetes like hypoglycemia or hyperglycemia that can land you in a coma or […]

2016-11-21T13:04:19-05:00July 7th, 2014|Nursing, patient engagement, Patients|1 Comment
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AJN’s July Issue: Diabetes and Puberty, Getting Patient Input, Quality Measures, Professional Boundaries, More

AJN0714.Cover.OnlineAJN’s July issue is now available on our Web site. Here’s a selection of what not to miss.

Diabetes and puberty. On our cover this month, 17-year-old Trenton Jantzi tests his blood sugar before football practice. Trenton has type 1 diabetes and is one of a growing number of children and adolescents in the United States who have  been diagnosed with either type 1 or type 2 diabetes. The physical and psychological changes of puberty can add to the challenges of diabetes management. Nurses are well positioned to help patients and their families understand and meet these challenges.

To learn more more about the physical and behavioral changes experienced by adolescents with diabetes, see this month’s CE feature, “Diabetes and Puberty: A Glycemic Challenge,” and earn 2.6 CE credits by taking the test that follows the article. And don’t miss a podcast interview with the author, one […]

2016-11-21T13:04:26-05:00June 27th, 2014|nursing perspective, nursing research|0 Comments
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Youth with T1 Diabetes Not Meeting A1c Targets: What Can Nurses Do?

By Jeniece Trast, MA, RN, CDE, clinical research nurse manager, certified diabetes educator, Children’s Hospital at Montefiore, Montefiore Medical Center, Bronx, NY

bloodglucosetestingDiabetes Care recently published an article showing that our youth with type 1 diabetes, especially those in adolescence, are not meeting glycosylated hemoglobin (HbA1c) clinical guidelines. The HbA1c is a blood test done every two to three months that shows how well controlled the glucose levels were over that time period. As much as this news is disappointing, I am not shocked by it. Type 1 diabetes is a challenging disease to live with at any age; however, the adolescent years definitely intensify the challenge.

As a nurse and certified diabetes educator (CDE), I take on many roles when caring for a teenager with type 1 diabetes: educator, team member, moderator, blood glucose assessor, advocate, cheerleader, and even role model (yes, I have type 1 diabetes also).

Challenges and responsibilities. When caring for these patients, keep in mind that type 1 diabetes is a difficult disease to live with on a day-to-day basis. People with type 1 have lots of important responsibilities just to stay alive: multiple insulin administrations each day; constant blood glucose checking; understanding the effects of exercise on glucose level both during and after exercise; balancing exercise, stress, food, and […]

2016-11-21T13:08:18-05:00February 13th, 2013|nursing perspective|2 Comments
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What to Do If the Nursing Board Takes Action Against You: A Lawyer and Former RN Advises

At 7 AM, when RN Michelle Flacco took over the care of 66-year-old Lester Scanlon, who had dementia and type 1 diabetes, she was notified that his blood glucose level was significantly elevated, at greater than 550 mg/dL. Ms. Flacco performed blood glucose tests three times during her shift, each time after Mr. Scanlon had eaten a meal, and each time his blood glucose level was elevated. However, Ms. Flacco didn’t notify Mr. Scanlon’s physician, nor did she administer insulin to the patient. The next shift, Mr. Scanlon was found unresponsive, with a very elevated blood glucose level. He was diagnosed with diabetic coma. The incident was reported to Ms. Flacco’s state board of nursing, and she was accused of professional incompetence. The board is seeking revocation of her RN license.

That’s the opening of “You’re Being Investigated by Your State Nursing Board” in the June issue of AJN. The case described is a composite, but it illustrates a situation that a nurse can find herself or himself in. The article, currently open access, is by Margaret E. Mangin, who practiced nursing for 12 years before becoming an attorney. For the past 26 years, she has practiced law in San Diego, primarily defending hospitals, nurses, and other health care providers. This is the latest installment of our Legal Clinic column. You might want to check it out. The table below gives the most frequent licensing violations, 1996 to 2006.

2016-11-21T13:09:59-05:00June 1st, 2012|nursing perspective|4 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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