Chronic illnesses are common health challenges because they occur throughout an individual’s life (Kralik, Paterson, & Coates, 2010). The improvements in the quality of healthcare have seen many children who would have otherwise succumbed to chronic illnesses grow into adulthood (Kralik & Van Loon, 2009). Therefore, there is a need to establish ways of providing the appropriate care throughout the different stages of life. Type 1 diabetes is an example of a chronic illness typified by the autoimmune-arbitrated destruction of beta pancreatic cells thus making it impossible for the body to produce insulin (Chiang, Kirkman, Laffel, & Peters, 2014). A person with this disorder relies on exogenous insulin for blood glucose control. This paper looks at type 1 diabetes care across the lifespan.
Infancy
The infant’s main need at this stage is developing a trusting bond with his or her caregivers. The main diabetes management goal is preventing and managing hypoglycemia through blood glucose monitoring and tailoring of diet as well as minimizing blood glucose vacillations.
Childhood
The child’s main needs during this stage include developing a sense of mastery and autonomy, participating in activities, and establishing self-confidence. In the later childhood stages, basic dexterities such as athletic, intellectual, creative, and social skills are nurtured. Preventing hypoglycemia and extreme blood sugar fluctuations due to irregular food habits and physical activities are the main goals. During hospital visits, an age-adjusted BMI should be computed to monitor the overall growth rate. The child should be observed for diabetes complications such as nephropathy and retinopathy. Other goals include positively reinforcing cooperation with treatment and customizing the regimen to allow the child to participate in school activities. At this point, the child needs to be educated on the importance of long-term and short-term blood sugar control.
Adolescence
Adolescence comes with body changes and problems with a sense of identity. There is an increase in insulin needs, which implies that the insulin regimen needs to be adjusted. Blood sugar control is thus complicated by body image issues. Additionally, there is a need to prepare the patient to changeover to a new diabetes care team. The patient also needs education on ways of assimilating diabetes care into their lifestyle. Failure to address these issues may lead to depression, eating syndromes, and dangerous behaviors such as smoking and alcohol consumption.
Early Adulthood
The empathetic substructure tends to decline as teenagers transition into adulthood, which has adverse effects on glycemic control. The American Diabetes Association endorses a good, realistic changeover plan to forestall the impending changes (Chiang et al., 2014). This plan should be initiated during adolescence. Some of the pertinent issues include money, insurance, obtaining medication supplies, and finding an adult care provider.
Middle Age
The pressures of life may complicate the management of blood sugar levels. Middle-age adults need to be educated on balancing their responsibilities with diabetes care, sexual performance, pursuing their careers, engaging their spouses in diabetes care, and informing other family members about the disease.
Older Age
Most people in this age bracket suffer from comorbidities such as cardiovascular disease and retinopathy. Diabetes care should consider these conditions and screen for other problems such as neuropathy and nephropathy. Foot care is also essential. The patient should have routine follow-up preferably four times a year to evaluate the efficiency of blood sugar self-monitoring, signs of diabetic complications, A1C, blood pressure, foot exam, and weight. The immunization process should adhere to the recommendations of the Centers for Disease Control and Prevention for people with diabetes (2016).
Conclusion
Changes across the lifespan are a reflection of the biological, cognitive, and psychosocial changes that occur throughout a person’s life. Therefore, it is important to customize care to meet the needs of each developmental stage.
References
Centers for Disease Control and Prevention. (2016). Diabetes type 1 and Type 2 and adult vaccination. Web.
Chiang, J. L., Kirkman, M. S., Laffel, L. M., & Peters, A. L. (2014). Type 1 diabetes through the life span: A position statement of the American Diabetes Association. Diabetes Care, 37(7), 2034-2054.
Kralik, D., & Van Loon, A. (2009). Editorial: Transition and chronic illness experience. Journal of Nursing & Healthcare of Chronic Illnesses, 1(2), 113-115. Web.
Kralik, D., Paterson, B., Coates, V. (2010). Translating chronic illness research into practice (1st ed.). Oxford, UK: John Wiley & Sons.