Infancy
(0–12 months)
|
Developing a trusting relationship or bond with primary caregiver(s)
|
Preventing and treating
Hypoglycaemia
Avoiding extreme fluctuations in blood glucose levels
|
Coping with stress
Sharing the burden of care to avoid parent burnout
|
Toddler
(13–36 months)
|
Developing a sense of mastery and autonomy
|
Preventing hypoglycaemia
Avoiding extreme fluctuations in blood glucose levels due to irregular food intake
|
Establishing a schedule
Managing the picky eater
Limit-setting and coping with toddler’s lack of cooperation with regimen
Sharing the burden of care
|
Preschooler and early elementary school
(3–7 years)
|
Developing initiative in activities and confidence in self
|
Preventing hypoglycaemia
Coping with unpredictable appetite and activity
Positively reinforcing cooperation with regimen
Trusting other caregivers with diabetes management
|
Reassuring child that diabetes is no one’s fault
Educating other caregivers about diabetes management
|
Older elementary school
(8–11 years)
|
Developing skills in athletic, cognitive, artistic, and social areas
Consolidating self-esteem with respect to the peer group
|
Making diabetes regimen flexible to allow for participation in school or peer activities
Child learning short and long term benefits of optimal control
|
Maintaining parental involvement in insulin and blood glucose management tasks while allowing for independent self-care for special occasions
Continuing to educate school and other caregivers
|
Early adolescence
(12–15 years)
|
Managing body changes
Developing a strong sense of self-identity
|
Increasing insulin requirements during puberty
Diabetes management and blood glucose control becoming more difficult
Weight and body image concerns
|
Renegotiating parent and
teenager’s roles in diabetes management to be acceptable to both
Learning coping skills to enhance ability to self-manage
Preventing and intervening in diabetes-related family conflict
Monitoring for signs of depression, eating disorders, and risky behaviours
|
Later adolescence
(16–19 years)
|
Establishing a sense of identity after high school (decisions about location, social issues, work, and education)
|
Starting an ongoing discussion of transition to a new diabetes team (discussion may begin in earlier adolescent years)
Integrating diabetes into new lifestyle
|
Supporting the transition to independence
Learning coping skills to enhance ability to self-manage
Preventing and intervening with diabetes-related family conflict
Monitoring for signs of depression, eating disorders, and risky behaviours
|
