Introduction

There has been a growing concern about the rampant increase of diabetes in children. Children and young people are the majority of people suffering from type 1 diabetes. According to Hanas (2007), type 1 diabetes results when there is a destruction of beta cells. Located in the pancreas, beta cells are attributed to producing insulin. The lack of insulin means that the level of glucose in the blood and urine is bound to increase. The main symptoms of type 1 diabetes include weight loss, fatigue, hunger and frequent urination.

Key priorities for implementation

According to the National Institute for Health and Care Excellence (2004), children affected by type 1 diabetes should obtain care from a team of professional medical practitioners. The care team should have members with apposite training in lifestyle, dietetic, clinical and foot care of young adults and children with diabetes. It is also important for patients with type 1 diabetes to have access to information about type 1 diabetes. This is crucial as it will enable them to better manage the disease by themselves. Children ailing from type 1 diabetes together with their families should be well aware that the target for control of diabetes (glycaemic control) is the achievement of HbA1c level lower than 7.5 percent without the disablement of hypoglycemia.

Screening for complications among children with type 1 diabetes is crucial as it will prevent further acceleration of the disease. Celiac and thyroid disease should be screened upon type 1 diabetes diagnosis in a patient (NICE 2004). Retinopathy, microalbuminuria and blood pressure should be screened when a person with type 1 diabetes reaches the age of twelve. This should be done annually after the attainment of twelve years. Mental health professionals should offer psychological support to the patients and their families. Nurses are very important in this directive because they are the ones who spend the most time with the patients and their families. Psychological disturbances such as family conflict, conduct disorders, anxiety and depression can impact negatively on the management of diabetes. These disturbances are therefore crucial to be kept at bay.

Guidance

Diagnosis should follow the criteria of the World Health Organization report (WHO) report carried out in 1999 (Fox 2008). Children and young people should be referred to a care team on the same day that the diagnosis has taken place. The multi-disciplinary care team should take into consideration that the patient may be suffering from other types of diabetes such as type 2 diabetes. This normally affects children whose family has a long history of diabetes or that the patient is obese at the time of presentation. Education about diabetes is important, therefore, the medical team should educate the patient and his family about the delivery of insulin, effects of diet and physical activity (NICE 2004). Diet plays a crucial role in the supervision of diabetes.

Children should have a daily intake of over 50% of carbohydrates in their food. Proteins should consist of 10 to 15% while fats should consist of 30 to 35% of the total food intake. Nurses are crucial in educating their patients on the best way to keep diabetes at bay. Complications such as hypoglycaemia and diabetic ketoacidosis may arise. Those with mild hypoglycaemia should receive immediate treatment whereby they are required to consume 10 to 20 grams of carbohydrate. Those with severe hypoglycaemia should receive treatment in a hospital setting. Children with diabetic ketoacidosis should be initially managed in a high-dependency unit.

Research recommendation

According to the National Institute for Health and Care Excellence (2004), there are certain areas in the treatment of diabetes that need further research. In children and young people, there should be an investigation into the best way to train healthcare professionals so that they can better educate the families of those with type 1 diabetes. There is also the need to carry further research on the effectiveness of insulin pump therapy and daily injections (Fox 2008). Medical researchers should also carry out extensive research to the effectiveness of invasive and non-invasive glucose monitoring systems. There should be research about the effectiveness of rehydration fluid, rehydration rate and albumin infusion. Research on the dose of insulin infusion is also crucial in the management of ketoacidosis. Research about the best possible ways of social interventions to curb cases of anxiety, eating disorders, conduct disorders and depression is crucial (NICE 2004).

In adults, extensive research will be invaluable in finding ways to lessen microvascular and arterial risk. Adults are at a higher risk of developing late complications as compared to children and young people. Medical researchers should assess the recall systems that allow longer intervals of complication and risk factor detection (Fox 2008). There is also the need to research on the usefulness of quality assurance systems used in inspecting complications.

Conclusion

Medical researcher should look into ways of developing the ways that doctors and nurses treat those with type 1 diabetes. With extensive research then treatment of diabetes will be effective and dependable (Fox 2008). It is vital that medical practitioners educate patients and their families on the effective ways that they can use to manage the disease. Self-monitoring of the level of blood glucose is important and therefore patients should possess that knowledge. Patients should also have adequate knowledge on what to do when the level of glucose in the blood decreases or increases.

References

Fox, C., & Kilvert, A. (2008). Type 1 diabetes. London: Class.

Hanas, R. (2007). Type 1 diabetes: A guide for children, adolescents, young adults – and their caregivers, everything you need to know to become an expert on your own diabetes. New York, NY: Marlowe.