By Jeniece Trast, MA, RN, CDE, clinical research nurse manager, certified diabetes educator, Children’s Hospital at Montefiore, Montefiore Medical Center, Bronx, NY
Diabetes 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 insulin; providing sick day care; assessing for and treating hypoglycemia; troubleshooting when things go wrong; carrying supplies at all times; and worrying about the disease’s future possible complications—just to name of few!
Particular stresses for teens. These obligations require education, clinical and psychological support, and motivation. Nurses can play a vital role in all of that. Additionally, teenagers want to feel “normal,” puberty occurs, growth spurts happen, peer pressures influence them, erratic lifestyles dictate their lives, they long for independence, and many other potentially difficult situations occur during adolescence. All of this contributes to the fact that these teens are not achieving optimal control.
What can nurses do? There are many things we can do with our teenage patients to help them achieve both their goals and our goals. […]