Skip to main content

Ambulatory Care for Children with Newly Diagnosed Diabetes

  • Chapter
Innovations in Paediatric Ambulatory Care

Abstract

Type 1 or insulin-dependent diabetes mellitus (IDDM) is one of the most common chronic childhood disorders, the incidence for children aged under 15 years in the British Isles almost doubling from 7.7/100 000 per year in 1973–74 to 13.5/100 000 per year in 1988 (Metcalfe and Baum, 1991). The lack of insulin production in IDDM results in high blood glucose levels (hyperglycaemia), leading to increased micturition by day and night, sometimes with uncharacteristic bedwetting, increased thirst, fatigue and weight loss. If undetected, severe fluid, electrolyte and acid base disturbances lead to vomiting, dehydration, coma and death. The presentation at diagnosis can vary considerably, from the acutely ill, ketoacidotic child with severe dehydration to the relatively asymptomatic child where the disease has been recognised in the early stages of its development.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Anderson, B.J., Auslander, W.F., Achtenberg, J. and Miller, J.P. (1983) Impact of age and parent-child and spouse responsibility sharing in diabetes management on metabolic control. Diabetes, 32 (supplement): 17A.

    Google Scholar 

  • Baum, J.D. (1990) Children with diabetes. British Medical Journal, 301: 502–3.

    Article  Google Scholar 

  • British Paediatric Association Working Party Report (1990) The organisation of services for children with diabetes in the United Kingdom. Diabetic Medicine, 7: 457–64.

    Article  Google Scholar 

  • Cowan, F.J., Warner, J.T., Lowes, L., Ribeiro, J.P. and Gregory, J.W. (1997) Auditing paediatric diabetes care and the impact of a paediatric-trained diabetes specialist nurse. Archives of Disease in Childhood, 77: 109–14.

    Article  Google Scholar 

  • Department of Health (1991) Welfare of Children and Young People in Hospital. (London: HMSO).

    Google Scholar 

  • Department of Health (1994) The Allitt Inquiry. (London: HMSO).

    Google Scholar 

  • Forsander, G. (1995) Family attitudes to different management regimens in diabetes mellitus. Practical Diabetes, 12(2): 80–5.

    Article  Google Scholar 

  • Hamman, R.F., Cook, M., Keefer, S. et al. (1985) Medical care patterns at the onset of insulin-dependent diabetes mellitus: association with severity and subsequent complications. Diabetes Care, 8 (supplement 1): 94–100.

    Article  Google Scholar 

  • Koizumi, S. (1992) Japanese mothers’ responses to the diagnosis of childhood diabetes. Journal of Pediatric Nursing, 17: 154–60.

    Google Scholar 

  • Lessing, D.N., Swift, O.G.F., Metcalfe, M.A. and Baum, J.D. (1992) Newly diagnosed diabetes: a study of parental satisfaction. Archïves of Disease in Childhood, 67: 1011–13.

    Article  Google Scholar 

  • Lipman, T.H. (1987) Length of hospitalisation of children with diabetes: effect of a clinical nurse specialist. Diabetes Educator, 14(1): 41–3.

    Article  Google Scholar 

  • Lowes, L. (1997) Evaluation of a paediatric diabetes specialist nurse post. British Journal of Nursing, 6(11): 625–33.

    Article  Google Scholar 

  • Lowes, L. and Davis, R. (1997) Minimising hospitalization: children with newly diagnosed diabetes. British Journal of Nursing, 6(1): 28–33.

    Article  Google Scholar 

  • McClowry, S.G. and McLeod, S.M. (1990) The psychological responses of school-age children to hospitalisation. Children’s Health Care, 19(3): 155–60.

    Article  Google Scholar 

  • McEvilly, A. (1991) Home management on diagnosis. Paediatric Nursing, June: 16–18.

    Google Scholar 

  • McEvilly, A. (1995) Liaison nursing — the diabetic home care team, in Kelnar, C.J.H. (ed.) Childhood and Adolescent Diabetes. (London: Chapman & Hal

    Google Scholar 

  • Metcalfe, M.A. and Baum, J.D. (1991) Incidence of insulin dependent diabetes in children aged under 15 years in the British Isles during 1988. British Medical Journal, 302: 443–47.

    Article  Google Scholar 

  • Moyer, A. (1989) Caring for a child with diabetes: the effect of a specialist nurse on parents’ needs and concerns. Journal of Advanced Nursing, 14: 536–45.

    Article  Google Scholar 

  • Moyer, A.A. (1993) The specialist nursing care of children with diabetes. Unpublished PhD thesis, King’s College, London.

    Google Scholar 

  • Muller, D.J., Harris, P.J., Wattley, L. and Taylor, J.D. (1994) Nursing Children: Psychology, Research and Practice, 2nd edn. (London: Chapman & Hall).

    Google Scholar 

  • Paediatric Diabetes Team, Newcastle and Gateshead (1993) Diabetes. A Book for Children and their Families. (Sussex: Boehringer Mannheim UK).

    Google Scholar 

  • Pinkney, J.H., Bingley, P.J., Sawtell, P.A., Dunger, D.B. and Gale, A.M. (1994) Presentation and progress of childhood diabetes mellitus: a prospective population-based study. Diabetologia, 37: 70–4.

    Article  Google Scholar 

  • Royal College of Nursing (1994) The Care of Sick Children. A Review of the Guidelines in the Wake of the Allitt Inquiry. (London: RCN).

    Google Scholar 

  • Royal College of Nursing Paediatric Diabetes Special Interest Group (1993) The Role and Qualifications of the Nurse Specialising in Paediatric Diabetes — a Working Party Report. (London: RCN).

    Google Scholar 

  • Royal College of Paediatrics and Child Health and the Joint British Advisory Committee on Children’s Nursing (1996) Developing Roles of Nurses in Clinical Child Health. Report of a Joint Working Party. (Royal College of Paediatrics and Child Health: London).

    Google Scholar 

  • Schneider, A.J. (1983) Starting insulin therapy in children with newly diagnosed diabetes. An outpatient approach. American Journal of Diseases of Children, 137: 782–6.

    Article  Google Scholar 

  • Simell, T., Simell, O. and Sintonen, H. (1993) The first two years of type 1 diabetes in children: length of stay affects costs but not effectiveness of care. Diabetic Medicine, 10: 855–62.

    Article  Google Scholar 

  • Swift, P.G.F., Hearnshaw, J.R., Botha, J.L., Wright, G., Raymond, N.T. and Jamieson, K.F. (1993) A decade of diabetes: keeping children out of hospital. British Medical Journal, 307: 96–8.

    Article  Google Scholar 

  • Visintainer, M.A. and Wolfer, J.A. (1975) Psychological preparation for surgical patients: the effect on children’s and parent’s stress responses and adjustment. Pediatrics, 56: 187–202.

    Google Scholar 

  • Wearmouth, E.M. (1994) Family awareness and the diagnosis of diabetes. Practical Diabetes, 11(3): 112–14.

    Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Copyright information

© 1998 L. Lowes and R. Davis

About this chapter

Cite this chapter

Lowes, L., Davis, R. (1998). Ambulatory Care for Children with Newly Diagnosed Diabetes. In: Glasper, E.A., Lowson, S. (eds) Innovations in Paediatric Ambulatory Care. Palgrave, London. https://doi.org/10.1007/978-1-349-14367-2_16

Download citation

  • DOI: https://doi.org/10.1007/978-1-349-14367-2_16

  • Publisher Name: Palgrave, London

  • Print ISBN: 978-0-333-68478-8

  • Online ISBN: 978-1-349-14367-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics