Wednesday, August 25, 2010


Juvenile diabetes


Juvenile diabetes is one of the most common chronic conditions to affect children all over the world and each day, over 200 children are diagnosed with type 1 diabetes. Although Diabetes is a metabolic disorder, it can have psychosocial effect, if not handled in the right manner. As a long term condition that affects day-to-day living, diabetes can be particularly stressful on the child and parents. Newly detected Diabetes impacts all aspects of a child's life and its management requires the parents to tackle challenges at multiple levels physical, psychological, social and educational. If not effectively addressed, a spectrum of psychological issues ranging from lack of confidence to severe depression may result. However with proper training, learning about diabetes and making small changes in life style as a family, you can live a fairly normal life.

In this article, we examine the need for counseling and the various counseling options that a parent has to help a child and themselves deal with such issues.


Counseling the diabetic child
A child diagnosed with diabetes is suddenly thrust into the unenviable position of dealing ith a chronic condition. Starting from dietary restrictions to insulin injections, the child has to come to terms with the all-pervasive impact of this condition. As a result, the child ay suffer from stress. Resentment, fear of being mocked at by peers, a fear of being branded as a 'sick' or 'ill' person, and anger at parental control on diet and activities are ome of the feelings that a child may experience. If allowed to build up, such feelings can have a debilitating effect on the child's mental and physiological health.

Parents can do a lot towards helping the child cope with diabetes. In fact, the attitude of parents plays a great role in forming the child's response to the condition. Paying enough attention to the psychological needs of the child can be as important as providing medication. By following these simple do's and don'ts, parents can empower the child as he/she work on responding to the condition.

Do not be over-protective. Many parents confuse precaution with apprehension and cross the fine line between being protective and over-protective. Understand that diabetes need not stop your child from leading a healthy, active life. Do not deter the child from participating in active sports and games in the mistaken belief that your child has to be protected.
2. Do listen and watch out for cues to your child's state of mind. Loss of appetite, sudden loss of interest in studies, reluctance to go to school, a listless attitude are some signs that your child needs help in coping with the condition.
3. Do not refer to the condition as a disease.It only helps to firm up an opinion that diabetes is to be feared and dreaded.
4. Do discuss the condition, its causes, treatment and precautions to be followed. An understanding about the physiological conditions and changes associated with diabetes will alleviate your child's fears about this condition and will equip him/her with the requisite knowledge to tackle it.
5. Do not express worries about the child's future, especially within earshot of the child.
6. Do not treat the child differently from his/ her siblings. This will only make your child more conscious about his/her condition.
7. Do take every opportunity to stress that diabetes is treatable.
8. Do focus on success stories of fellow diabetics from your child's area of interest - for example, successful cricketers, or athletes who are diabetics. Your child will profit from such role models.
9. Letting some one know about the fact that your child is diabetic should occur as naturally as divulging any other personal fact about yourself. If someone were to notice your child taking a shot and wondered what it was or why it was so, that would be a reason to explain! Don't express being diabetic as a negative thing or something that defines a person. Let it come naturally but definitely don't hide it. Be short, precise and positive while telling about it.
10. Be realistic in the goals set of your child.
11. Do set a personal example. Follow a healthy regimen of diet and exercise yourself to make it easy for your child to adhere to his.
12. Be understanding during the instance that your child deviates from the prescribed routine – your child is still a child and there may be occasions when he she feels the need to bypass the routine.

Counseling partners and caretakers
Juvenile diabetes impacts the entire family, not just the affected child. The parents of a diabetic child are also subject to stress, although for different reasons. In the case of parents, possible stressors are a fear of societal ridicule, apprehension about a girl child's marital prospects, worry about the child's longevity and future and sometimes guilt on not being able to protect the child from this condition. Counselling of parents and caretakers can go a long way in helping them tackle the emotional impact of this condition. While child counselling sessions help to assure the child, reinstate confidence and also infuse the belief that diabetes is a manageable condition, parental counseling seeks to allay the parents' fear regarding their child's future.

External sources of counselling
Depending on the extent of the psychological impact, counselling of the child is therefore not just desirable but even required. Although parents may be able to provide suchadvice, external help and counseling can effectively supplement the efforts of parents.

There are various counseling options available.
These are :
Family physician: The family physician is often the first line of support. The family physician will have an intimate knowledge of the child, his/her interests, and temperament. Further, the family physician enjoys the trust of the parents and the child alike. A talk with the family physician may be a timely confidence-booster.

Friends and family: Advice from friends and family, especially fellow-patients can also be very effective. A family member or friend who is successful and happy, despite such a diagnosis can be a very effective role model.

Online and offline support groups: Online support groups for both children and parents alike, provide a global network of support and also resources that the parents and child can tap into. Online support groups overcome the barriers of distance and allow parents to communicate, share and get answers to mutual concerns on bringing up a diabetic child.
Professional counseling: Where the emotional impact is deeper, professional counseling is not just desirable but required. Where thepsychological impact has resulted in mild or severe Depression,advice from a psychiatric professional is mandatory.

Conclusion
Dealing with diabetes is not just about taking medication, it is about dealing with its invisible and intangible effects. Counselling is one of themost potent tools that parents have to successflly manage the psychological consequences of this condition.
For stories on successful role models for children and more tips to young people on self management, coping and living with diabetes please visit www.dawnyouth.com

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