Pediatric diabetes really changes how someone lives their life at an early age. It makes socializing and living a normal healthy life a little more complicated, and can be really difficult for patients who are diagnosed at a young age. I think that the primary thing that stuck with me this week was how important it is to customize plans of care for everyone, and to teach them exactly how to live with their diabetes while still living fulfilling lives. Our case study this week involved someone who swam in meets, and did not want to eat so that his times could be better. However, it is really important for him to have sugars in his system, and to closely monitor his sugars. It is possible for him to be a successful swimmer with diabetes, and several diabetic swimmers have made it to the Olympic level, it will just be different for him than it is for others. It is important for patients like our case study, that all those who work closely with them know what to do when their sugars get low, and also to trust the patient within safe bounds. I have friends who grew up with diabetes, and it really changed how they lived their lives, but they are all healthy and happy. I feel bad for those kids who have such a large burden of diabetes, but they can be happy and healthy with proper self-care.
It seems like there are quite a few resources for the diabetic uninsured. It must be scary to find out you have diabetes and will need medication to live, but to know that you cannot afford it. That is one of the reason’s it is so important that we connect patients with resources and that we have a thorough understanding of what is out there for our patients. It saddens me that some people probably do not know about all of the resources they could take advantage of.
This week we talked about diabetes and pregnancy, and WOW. It can be really dangerous for baby, and for mom. I played Shelby in a mini Steel Magnolias thing last semester, and if I had known all of the information I do now, it would have gone so differently. I am going to make diabetic teaching to those who are pregnant a big priority, and make sure that I am not only thorough, but that they understand what I am teaching and how to apply it.
Diabetics can have healthy babies, but they need to be very careful, and watch carefully over so many areas of their lives. Exercise, diet, and any other health complications need to be considered for every patient. It is very important that the patient worry not only about too much sugar, but recognizes that her likelihood of a severe episode of hypoglycemia is greatly increased. Changing out medications, something I will make sure I always look into for the patient when administering medications, is very important if any are not pregnancy friendly. Overall, patients need to exercise caution and be aware of how to solve problems that arise, including changes in insulin dosages.
This topic was really interesting and enlightening!
This week was super interesting, as usual I loved our case study discussion. I love the case studies, because they really make me think, and they are generally where I learn the most. This week, we talked about teaching a patient about her diagnosis and how to manage it, despite a language barrier. We came up with a lot of great ideas, such as using a translator and different methods of checking for understanding, including patient demonstration and asking her to explain everything back to us. I loved one of my team mates reminders to keep the teaching sessions short, she suggested 30 minutes. Learning about diabetes can be overwhelming, especially if you are potentially reeling from a new diagnosis. I know it is a lot to take in, even as someone who has been studying it for a little while. Patients are changing their entire lifestyle, and we need to make sure we take time with them. I suggested to the group visual aides, and I think someone else did too. I think that it is important that we give the patient as many resources to take home with them as we reasonably can. I know that my questions always begin after the meeting with the doctor, and even after some time with the nurse. We need to make sure that our patient has the resources he or she needs to continue to learn about diabetes and how to manage it.
In terms of hypo/hyperglycemia specifically, I read an interesting article about a study that showed that those who learned to manage their diabetes intensely may at first experience more severe episodes of hypoglycemia, but will overall have lower episodes of both hypo/hyperglycemia. I wish the study that was discussed had more information about things such as rates of amputation and other such complications. I think it is important that our diabetic patients know just how much of an impact on their overall life management can make. I loved the website where Diabetes SmartPro sent me for the article. It had a lot of resources such as free cookbooks and forums that I think would be a really big help to not only those with diabetes, but their families as well. It is certainly a disease that affects the entire family.
I missed last weeks post because I was traveling, but I’m going to go ahead and put it in here, just to get it out of my system.
Having Diabetes: Pathophysiology and Epidemiology
During our “Having Diabetes Week,” we talked a lot about what the risk factors were for diabetes, and how it was diagnosed. This was a ton of information, but it was all super useful. We based a discussion around a case study. The subject was a woman in her late forty’s who was a single parent, Hispanic, lived a sedentary lifestyle, and was overweight. She ate out at least one meal a day, and came into the clinic with labs that looked a lot like a diabetic patient’s would. We determined, that though we were unable to diagnose her, she likely had diabetes and was at the very least at a high risk to develop it. This discussion brought out a lot of information about lab values, and we looked into a lot of risk factors. For example, this person also had high LDL values and low HDL, which is common in diabetic patients. Overall, this week really helped me to understand what to look for in patients as warning signs that the may develop diabetes, and it taught me what to look for in lab values. It was super interesting material, and it caused me to think a lot. I like that there was such a thorough discussion on the topic, because my classmates pointed out information I originally thought irrelevant, like the lipid values.
Medical Nutrition Therapy and Carbohydrate Counting
This week we talked about helping patients to change their diet and live a healthier lifestyle, so that they can manager their diabetes. We did a carbohydrate counting game that I found fun, and informative. I never realized just how many carbohydrates were in our food! They are in almost everything, and it is really important that our patients know this. Knowing how to make smart choices about food affects our diabetic patients in a really big way. Food is not just a social staple, especially for our diabetic patients. Our case study this week was designed around helping a different patient to create a new diet for herself, and whether or not she could be successful. She was also overweight, had children and lead a sedentary lifestyle. She also loved to prepare fried foods for her family. I think that ultimately, we decided she could be successful, but she needs to take small steps. Learning how to prepare meals that her family will enjoy, but that will help their health (and hers) is really important for her. We also need to make sure that the patient understands that fried foods can be a fun treat, but that they should not be a lifestyle. For this patient, lifestyle changes in eating are going to be crucial, and likely difficult. It can be hard to give up those yummy, greasy foods, and her body will not like the changes at first. As the nurse working with her, it is going to be super important to offer moral support and encouragement. It would also be great if she could live a less sedentary lifestyle. Patients and medical professionals alike often struggle to find time to exercise, and when you are tired from a long day, it is easier to sit down and rest. Eating a better diet will not only help lower our patient’s risk for diabetes, but will give her more energy to perk up her lifestyle a little bit. Teaching the patient that baby steps in all aspects of change are important and not to overwhelm herself. Small changes like walking for 15 minutes or giving up soda make a huge difference.
I loved this topic, it was so useful for me in learning how to teach patients and how to support them. I knew that trying to make several changes at once was hard for me, but I think we often through big changes at our patients all at once. It is expensive for them to come in repeatedly though, so perhaps creating a plan of change with the patient that spans time and follow up calls would make the health care more accessible, and ultimately create better outcomes for patients.
My name is Kayla Elliott. I am a mother, who is working hard to provide for her daughter and to go to school at the same time! I want to work in dermatology. I love dermatology and I love the way that nutrition affects your overall health. It is super important that we start with what we are taking in/lifestyle when looking at what is wrong.
Throughout this blog, I am going to be posting reflective journals. These journals are designed to help me fully explore what I am learning in my classes, and to help me fully absorb that information. They may be a little lengthy, but I promise to always try and keep them to the point.