Specialisation: Type 1 Diabetes

Case Study: Type 1 Diabetes

Type 1 diabetes is a complicated condition that requires careful control. It may be more complex for adolescents, and control often deteriorates. Family dynamics and school support as “significant others” in the circumstances where a comprehensive family assessment of health and social needs is recommended to adapt support. This case study aims to show how adolescence may have altered a 14-year-old boy’s diabetes self-management, background, assessment framework, current nursing plan, and recommendations on how to deal with the condition.

Case Study

Felix was 14 when he was diagnosed with type 1 diabetes six months ago. He lives with his single mother and 10-year-old sister. In this case, Felix represents the hardships teenagers with this disease encounter and the issues families and professionals confront.

Common Assessment Framework

Hingle et al. (2019) recommended family-focused therapies for adolescents with diabetes, which CAF then recommends. As a multi-agency document, it allows information sharing and care collaboration with the family and young person. Significantly, it supports a family-focused team and was used to assess Felix and his family’s diabetes management challenges and how to help them.

Background

About 30% of newly diagnosed type 1 diabetic children have diabetic ketoacidosis as a result of weight loss and fatigue being misinterpreted as puberty symptoms. Felix was critically ill and needed intense DKA route care to stabilize as he recovered after 48 hours and started numerous daily subcutaneous insulin injections. He self-managed his insulin injections on day four after a systematic instructional strategy described in the Best Practice Tariff that included a dietitian introduction to carbohydrate counting, exercise, and a balanced diet. Most importantly, follow-up assistance with structured diabetic self-management education from diagnosis is crucial for diabetes management (Holmqvist, 2020). Felix’s mother realized early on that Felix would benefit from learning to deal independently and declined scheduled education visits, believing they were managing themselves. However, Felix was at risk due to his young age and the responsibilities he was given after a life-changing diagnosis.

Current Nursing Plan

Notably, less than 50% attendance has plagued Felix’s education. He missed school due to migraines, stomach pain, and hyperglycemia-related “high blood sugars” after diagnosis. Gazerani (2021) found that high and low blood glucose levels can affect children’s education through poor concentration, mood, and behavior. Due to a lack of diabetes knowledge, school workers may mistake these behaviors as disruptive or accept illness and absence more easily. Felix must evaluate how school absenteeism affects academic performance. Van Duinkerken et al. (2020) found that childhood diabetes lowers cognitive scores in most domains, with executive cognitive aptitude improving problem-solving, planning, organization, and working memory.

Consequently, the CAF assessment revealed Felix’s dyslexia and academic underachievement. A child’s safety, long-term well-being, and academic achievement depend on proper diabetes care in school and daycare. Felix’s school could be a “significant other” and protective factor if the diabetes team works with it to meet his diabetes requirements during school hours. With an emphasis on “duty of care,” new legislation provides advice and guidance for supporting children with medical issues at school. Holmqvist (2020) proposed statutory guidance to oblige English schools to support children with medical illnesses, emphasizing the school’s position as a significant other. Education, health, and care programs for children with invisible needs at school are intended to make their needs more obvious.

Conclusions

Overall, adolescents like Felix and his family confront significant challenges. As a result, structured diabetes education to increase adherence to the regimen cannot be performed without considering family dynamics and the cognitive capacity of the young person and their family. Therefore, it is recommended that CAF documentation as part of a family assessment of children newly diagnosed with type 1 diabetes may alert healthcare professionals working with children like Felix who have high-risk factors and prevent many diabetes care issues.

References

Gazerani, P. (2021). Migraine and mood in children. Behavioral Sciences, 11(4), 52.

Hingle, M. D., Turner, T., Going, S., Ussery, C., Roe, D. J., Saboda, K., … & Stump, C. (2019). Feasibility of a family-focused YMCA-based diabetes prevention program in youth: The EPIC Kids (Encourage, Practice, and Inspire Change) Study. Preventive medicine reports, 14, 100840.

Holmqvist, M. (2020). Medical diagnosis of dyslexia in a Swedish elite school: A case of “consecrating medicalization.” The British Journal of Sociology, 71(2), 366-381.

Van Duinkerken, E., Snoek, F. J., & De Wit, M. (2020). The cognitive and psychological effects of living with type 1 diabetes: a narrative review. Diabetic Medicine, 37(4), 555-563.

Three Forms of Diabetes Mellitus

Diabetes is among the chronic conditions that contribute to millions of deaths globally. Diabetes Mellitus is a disease caused by low production of insulin by the pancreatic cells or the body does not use of insulin in the control of blood sugar levels (NIDDK, para. 1-3). A hormone called insulin controls blood sugar and is released from the pancreas when the level of blood glucose rises, such as after eating. Diabetes can contribute to hyperglycemia, which can affect the functioning of various body organs such as the kidney and liver (NIDDK, para. 1-2). Circulation sugar levels return to normal due to insulin’s stimulation of the liver’s metabolization of glucose and the removal of glucose in the body by muscle and fat cells. Diabetes can occur in three forms, namely, Diabetes Type 1 (T1DM), gestational diabetes, and type 2 diabetes (T2DM) (Nall, para.1). Therefore, this paper seeks to assess the causes of the three forms of diabetes mellitus.

Causes of Type 1 Diabetes

T1DM is caused by a reaction involving the destruction of the pancreatic beta cells responsible for producing insulin. Genetic traits passed from parents to their offspring can cause type 1 diabetes. Environmental factors such as viral infection can create room for type 1 diabetes. Research proves that viral infections such as the Human Enteroviruses (HEVs) associated with polio, can expose the beta-cells that produce insulin to attack the body’s immune system. This type of diabetes affects children more than adults (Nall, para. 2-4).

Causes of Type 2 Diabetes

T2DM is caused by risk factors such as unhealthy lifestyles, which contribute to being overweight or obese in most adults. Some unhealthy lifestyles include consuming processed foods with high sugar content that contribute to an increase in weight (Higuera & Lawler, para. 2-4). The failure to adhere to dietary recommendations is also a contributing factor to the development of diabetes in most adults. The high sugar, salt, and fat contents in most of the diets that adults consume contribute to obesity, and in expectant mothers, the probability of delivering obese children is high. Age can also be a causing factor of this type of disease since most older adults above 50 years engage in unhealthy lifestyles, especially after retiring (Higuera, V., & Lawler, para. 1).

Causes of Gestational Diabetes

Previous gestational diabetes during pregnancy can cause gestational diabetes in the future. Some causes of T2DM, such as obesity, can contribute to gestational diabetes, especially if an expectant mother is overweight. Age is another cause since older expectant mothers are likely to experience gestational diabetes due to unhealthy lifestyles that can cause the accumulation of fat deposits in the body and high blood pressure (Welch & Bennington-Castro, para. 3-4). Placental hormones such as growth hormones can also prevent pancreatic cells from producing sufficient insulin. Prediabetes can also contribute to the development of gestational diabetes since the body has signs of developing the health condition (Welch & Bennington-Castro, para. 2).

Conclusion

The general causes of the three forms of diabetes generally include unhealthy lifestyles such as consuming processed diets with high sugar and fat content, which contribute to hyperglycemia and are a health risk to many children and adults, including expectant mothers. This topic is essential to educate the general public on how to live healthy lifestyles through regular exercise and adhering to the recommended nutritional diets with low sugar, salt, and fat contents that can contribute to obesity.

Works Cited

NIDDK. (2019, March). Symptoms & Causes of Diabetes | NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/symptoms-causes

Higuera, V., & Lawler, M. (2019, May 2). Type 2 Diabetes Complications: Heart Disease, Diabetic Retinopathy, Neuropathy, and More | Everyday Health. EverydayHealth.com. https://www.everydayhealth.com/type-2-diabetes/treatment/type-2-diabetes-complications-heart-disease-diabetic-retinopathy-neuropathy-more/

Welch, A., & Bennington-Castro, J. (2020, December 3). What is gestational diabetes? Symptoms, causes, diagnosis, treatment, and prevention | everyday health. EverydayHealth.com. https://www.everydayhealth.com/gestational-diabetes/guide/

Nall, R. (2021, November 30). Diabetes: Symptoms, treatment, prevention, and early diagnosis. Www.medicalnewstoday.com. https://www.medicalnewstoday.com/articles/323627#type-1-diabetes