NURSING CARE FOR TACKLING DIABETES CHILDREN IN UK

The effect of nursing care for tackling diabetes children in UK

The effect of nursing care for tackling diabetes children in UK

Summary

Diabetes mellitus is one of the most common long-term conditions in childhood. The management of children and young people is predominantly carried out by general paediatricians with a special interest in diabetes, together with paediatric diabetes specialist nurses and dieticians. Various guidelines and recommendations have been published with the aim of improving standards and quality of care; however, surveys conducted in the United Kingdom at periodic intervals have regularly shown deficiencies in the provision of care for these children and young people. With intensification of insulin regimens, education of the child and family is the cornerstone of management with a view to enabling self- care.

Targets of each service should be to improve glycaemic control and thereby to prevent complications. Psychological support, social services, counselling, ophthalmology, and podiatry should be available. To ensure that care is of the highest standard, the team should have access to good clinic and hospital facilities and adequate manpower. Services should be commissioned accordingly to meet the demands of the local population. Regional networks form an important forum to discuss case load, sharing of resources, training for consistency in the region, and collection of outcome data with contribution to national audit.

I will do secondary reserach of 10 preschool children aged 2-6 years recruited from kindergartens in UK, 6 of whom were overweight or obese. Each was followed for 12-18 months. We will confirmed previously described risk factors and showed how these interacted to produce diabetes in some but not all at-risk children. Despite much rhetoric in the literature about holistic care of the preschool child, we would struck by the lack of coordinated professional input to the needs of children at risk of diabetes and by the absence of nursing input in particular. We will argue that a “whole-systems” nursing role, based in the community and with remit that includes clinical care, education, and policy, is urgently needed, as well as review examples of such roles from other countries.

Introduction

Diabetes is the most common endocrine disorder of childhood and is a life long chronic condition (Court and Lamb 1997:106). Normally, cells in the pancreas secrete hormones necessary for energy production, regulating blood glucose. Insulin, produced in beta cells, 'lowers blood sugar by allowing glucose to move from blood to the cells' (Phillips 2000:7). When the beta cells have been destroyed for one reason or another diabetes results (www.diabetes.org.uk). The most likely cause is abnormal reaction of the body to the cells' (www.diabetes.org.uk), which 'may be triggered by a viral or other infection' (www.diabetes.org.uk). Infection may also bring to light an underlying diabetes and exacerbate the symptoms e.g. tonsillitis.

'The onset of diabetes in childhood is rapid' (Craig 1982:1), sometimes over a period of only a few weeks. 'Diabetes in childhood is an insulin-dependent disease with very few exceptions with characteristic symptoms, which makes it an easily recognizable condition' (Shield and ...