Psychosocial Issues for Children and Adolescents With Diabetes: Overview and Recommendations

The psychosocial impact of diabetes in childhood is ubiquitous and involves the entire family, as well as schools and society as a whole. The International Society for Pediatric and Adolescent Diabetes (ISPAD) developed guidelines in 2000 to assist health professionals in the management of young people with diabetes. These guidelines are based on the St. Vincent Declaration, the Declaration of Kos, and the Declaration of the Americas, which define the rights of all people with diabetes and focus on significant areas of responsibility for those involved in the care of diabetic children and adolescents.This article addresses and expands the section of the ISPAD guidelines dealing with psychosocial issues in children and adolescents with diabetes in order to aid in the diabetes management decision-making process. The goal of both this article and the ISPAD guidelines is to aid in the development of diabetic children into well-adjusted adults with the highest possible degree of diabetes control.Diabetes in infants, toddlers, older children, and adolescents poses serious physical, mental, and emotional challenges. Striking a balance among hypoglycemia/hyperglycemia, growth/development, and other life factors is not easy for health care providers, patients, or families. In addition, personal, family, or environmental conditions present before the onset of diabetes may compound the delicate balance needed to maintain good glycemic control. Therefore, there is a great need, especially at the time of initial diagnosis, to assess the developmental, behavioral, and psychosocial history of children with diabetes and their families.Assessment should occur both at the time of diagnosis and periodically thereafter. If problems are identified, early interventions should be initiated.Any potentially life-threatening condition has some psychological impact, and that of diabetes is profound. If the care regimen is complex, the impact is greater in terms of financial cost, misunderstandings, external influences (e.g., patients may be accepted …