Changes: How A Diabetes Diagnosis Can Impact The Family
It's a moment most parents of a child diagnosed with diabetes will always remember, the moment a doctor confirmed for them that indeed their hunch was right, something was going on outside the norm. But what happens after that moment?
And going forward for the family what changes big or small will need to be made in their homes and lives to help support their child or family member now diagnosed with a life-long condition? We spoke with our own Kathryn Skuza, pediatric endocrinologist at Memorial Hospital of Converse County, about how families are impacted by a diabetes diagnosis, what changes they can make to support the health of their child, and how those changes can and should be rolled into the entire family.
"No matter how one approaches the topic with the family of a child/ adult with newly diagnosed Type 1 Diabetes [T1D], it is always a powerful shock. T1D changes aspects of our lives so fundamentally dear to us: FOOD and ACTIVITY. Families have to re-examine what's healthy and what is not," said Dr. Skuza. "At this point, I usually reassure families that their food choices won't change much, but they will need to learn how to count the carbohydrates and how to make meals and snacks more predictable."
Dr. Skuza has been working with those diagnosed with diabetes, particularly the youngest amongst us for the better part of her career. A point she reflected on when it came to the various insulins now available and how they help those diagnosed at meal times. "So much has changed since the introduction of Humalog in the 90s followed by Novolog and Apidra. These rapid-acting insulins allow an individual to eat a meal just after the injection. Please note that when regular insulins were used to cover meals, one had to wait 30 minutes after the injection before eating. And at that time basal insulin was two doses of NPH – one at breakfast, the other at bedtime – with its peak action that needed coverage with carefully planned food. Since 2000 it has been replaced by once-daily, peak-less Lantus and other basal insulins. As a result, glucose control has become easier to achieve."
Not everything can be left to simply utilizing Insulins or medications, however, and a well rounded dietary approach is often recommended. "After the initial shock of diagnosis and the daily routine of insulin injections and meal coverage, I begin introducing healthier food choices – the same I recommend to all families in my pediatric practice. Our families also have access to Ashley Littleton, dietitian, and certified diabetes educator, here at the Medical Office Building on Center Street," stated Dr. Skuza. "Healthier food choices are available at both Safeway and Douglas Grocery. The trick is to watch both the carbohydrates in the Nutrition Facts and the list of actual ingredients. This healthier approach should involve the entire family, not just the member with T1D – EVERYONE EATS HEALTHY!"
While mealtimes and food choices are the first series of changes many newly diagnosed diabetics face, the emotional care and support of these individuals as they progress through the myriad of lifestyle changes cannot be ignored. "No less important is the emotional care that families with T1D need. Each diabetes follow-up visit is a cheerleading event which attempts to meet the patient and his/her family where they are and provide solutions to actual issues they are facing. The fingerstick A1c now available to our families makes it easier to track these improvements. Soon we will start using the Diasend/ Glooko system that will allow us to format blood sugars easily in log diary format from various glucometers."
Grappling with a new diagnosis and learning all about it, insulins, medications, follow-up visits, meal times and glucose monitoring can often feel overwhelming for parents, caregivers and especially those who are newly diagnosed. But Dr. Skuza reiterates the need for normalcy in routine amongst families in her care. "I also reassure newly diagnosed families that the activities in which the child or adolescent has been participating CAN CONTINUE! There are some safeguards the family must follow, but swimming, baseball, basketball, football, soccer, dance, and others are ABSOLUTELY POSSIBLE. There is no reason for someone with T1D to not live a more normal life. And we are here to help."
A diagnosis of diabetes can certainly present challenges, lifestyle changes, and added considerations to families. But with care and a plan to work together as a family and with your health care provider, the diagnosis doesn't have to mean a 180, "The more comfortable the parents are with T1D and its responsibilities, the more comfortable and natural the child is."
If you or a member of your family would like to consult with Dr. Kathryn Skuza, be sure to reach out to her at our Medical Office Building at 307.358.7300.