Medical Neglect in Children and Adolescents with Diabetes Mellitus
- PDF / 528,517 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 53 Downloads / 206 Views
TREATMENT APPROACH
Medical Neglect in Children and Adolescents with Diabetes Mellitus Larry A. Fox 1,2 & Erin Pfeffer 2 & Jennifer Stockman 3 & Sandra Shapiro 4 & Kathleen Dully 4
# Springer International Publishing AG, part of Springer Nature 2018
Abstract Diabetes mellitus was a fatal disease for thousands of years, but the discovery of insulin in 1921 and major substantial improvements in care have made living with diabetes a chronic rather than fatal disease for many people, including children and adolescents. Diabetes mellitus is a lifestyle-altering diagnosis for the entire family. In some families, children and adolescents do not get the daily care they depend upon. This article reviews the consequences of medical neglect of children with diabetes and the optimal community response to concerns of medical neglect of diabetes. Criteria for placement in foster or substitute care are suggested. Keywords Diabetes . Adherence . Neglect . Hyperglycemia . Hemoglobin A1c . Foster care . Children . Adolescents
Diabetes mellitus was fatal until the discovery of insulin in 1921 (Bliss 2007). This and many advances in diabetes management since then have made living with diabetes a chronic rather than fatal disease. Patients with type 1 diabetes (T1D) can now expect to live long and productive lives, but only if they are willing, and cognitively able, to follow a complex routine of daily self-care, and have the psychosocial and family support to do so. Children are a special population in that they do not have the cognitive skills and maturity necessary to manage their diabetes independently (Fonagy et al. 1987; Follansbee 1989). Support and supervision from a responsible adult caregiver is of upmost importance, and without this help, children with T1D can be at grave risk of acute and chronic health complications. Children whose diabetes care has suffered because of a lack of adult supervision and support may require intervention and assistance from child protection agencies (Geffken et al. 1992; Jenny, and Committee on Child Abuse and Neglect, American Academy of Pediatrics 2007;
Boos and Fortin 2014). In fact, in a retrospective review (Fortin et al. 2016b), T1D was the most frequent diagnosis of 154 children reported to child protective services for medical neglect, present in ~10% of patients. This comprehensive review is the first in the literature concerning medical neglect in children with diabetes, including recognition, contributing factors, and how child protective agencies should respond to accusations of medical neglect in children with diabetes. Standards of care for management of T1D and the consequences of poor management (i.e., shortand long-term complications of T1D) are reviewed first to give the reader a framework of necessary care for this population. Although the focus is children with T1D, much of the information is also applicable to children with type 2 diabetes (T2D), although weight management issues and lifestyle changes play a much bigger role in the management of T2D.
Methods * Kathleen
Data Loading...
