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For those of you who were diagnosed with diabetes before the age of 18, I'd like to know what it was like when you took over your diabetes self-management as an adult. How did you feel? What problems did you face? And what helped you most with the transition?
Studies show that the transition to adult care services for young people with diabetes isn't optimal. One such study, in the January 2009 issue of Pediatrics, states that diabetes-related hospitalization rates increase in the two years after transition to adult care. Other factors — such as previous diabetes-related hospitalizations, lower income, female gender, and living in areas with low physician availability — were also associated with higher hospital admission rates compared with those who were transferred to a new allied health care team with no change in physician; those individuals were 77 percent less likely to be hospitalized after the transition.
Transitioning from childhood to adulthood can be challenging. You have greater independence and experience a lot of change, such as graduating high school and starting college, a new job or both. You may still live at home and go to school or work, or you may move out and have responsibility for supporting yourself and making or providing your own meals. Your schedule is also likely different. With all these changes occurring between ages 18 and 30, it can be hard to make diabetes self-management a priority. However, if you plan to stay healthy for many years to come, your health must be your main concern.
For those of you looking ahead to the transition to adult diabetes management, start planning now. Ask your parents, guardian or caregiver to help you learn how to book your own medical appointments and communicate with your insurance company. If you won't be covered by your parents' insurance after graduation, seek assistance for other healthcare options available in your area. Be prepared to ask your doctor questions and pick up your own prescriptions.
In addition to your doctor and parents or guardians, please establish a network of friends at school and work with whom you're comfortable sharing your needs. I heard a sad story today. My client's niece who had diabetes type 1 died at the age of 17. She went to a party with a date who she really liked. She forgot to bring along her insulin and was either afraid to or didn’t want to ask her date to take her home to get it. She died on the couch while they all were watching a video. Her friends had no idea and said that she always carried her supplies with her.
Please share your stories. We as health care providers want to improve our services. We want to know how we can better help you through the transition to adult diabetes care.
Have a good week.
Nancy Klobassa Davidson, R.N.
Peggy Moreland, R.N.
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My 15 yo son is alone in his diabetes hell. We know no other teens with T1. He hasn't been able to move forward from his dx in 2005 and feels that he is going to die any day. We have a chance to take him to a CWD conference this summer but have no $ for travel. Any ideas for grants to get us there?
This is such a sad story. Those of us on insulin must always have our glucose tablets on hand and a medical bracelet.
The info you've shared is very informative. It is important the Diabetes must be detected and managed at the early stage. Healthy Diet or specialized diet for this of disorder must be implemented.
Zeke and Sara: Type 2 Diabetes: Symptoms for hyperosmolar hyperglycemic state (HHS) can take several days to weeks. However, diabetic ketoacidosis (DKA) in type 1 and type 2 diabetes tends to evolve over a much shorter (<24h) time period. Occasionally, a patient may develop DKA with no prior clues or symptoms.
I agree with Zeke. People often misunderstand and think it's because the person doesn't have their insulin that this happens. It's more likely low blood sugar, since this happens rather quickly (often in a matter of minutes), and blood sugar that is too elevated takes several days of increasing elevation to cause symptoms that would lead to death.
I don't get it. The niece presumably died of low blood sugar, not high, so not having her insulin with her is not germane. Not having glucose with her, that's a different matter.
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