Letting diabetes take over
The most challenging thing is when the child is depressed or denies his or her diabetes. In a sense by denying it, the child is letting diabetes take over. Instead of trying to control the diabetes and get on with life, the diabetes ends up controlling the child.

Christina Luedke, MD, PhD, Physician

 

Social difficulties
Some of the challenging things for kids and teens are dealing with peers, their social life, their body image, and getting shots in the arms, legs, and stomach. Kids just want to eat on the fly, and they want to eat junk. Socially, I think it’s very difficult. If they go to a movie in the evening and they still need their 8:00 or 8:30 pm injection, I’ll say to them, “You know what? Just run out of the movie, your mom will drive up and give you the injection and back in you go.” It’ll become easier. If they want to do sleepovers, I recommend doing it in your own house for a while, and that’s when I say to parents that they should educate their child’s friends’ parents. The more education you put out there in your child’s world, the better off your world is going to be.

Maureen Powers, RN, DNE, Registered Nurse

 

Helping parents
Sometimes, parents can be more challenging than treating kids. Parental support is essential in allowing the child to succeed, so parents who are not 100% on board pose the toughest challenge for me. I lay out the facts as they are and give solutions back to the parents. As a short term solution, we sometimes send out a visiting nurse to help out the parent at home. Another challenge is when a parent also has diabetes and worse yet, if he or she has complications from diabetes. There is a lot of guilt there and a lot of projection of his or her situation on the child. It is important to help the parent move beyond this in order to help the child.

Maryanne Quinn, MD, Physician

 

Eating as a planned process
What seems to never become easy and is always a challenge is the lifestyle change, particularly eating. Eating has to become a planned process. The patient with diabetes has to think about the time of the day, the amount of food, the balance of food, carbohydrates, proteins and fats. That is not a natural way to eat. There is always the concern about not eating enough, eating too much, and eating at the right time. I often ask patients after they had diabetes for a few months, “What is the most difficult part about diabetes for you?” Most often patients express this challenge as the major issue. I think that this never goes away. It’s always difficult. It’s always a challenge. Most people cope with it, adapt their lifestyle, and get into certain habits, but for some it’s just very burdensome and of course many don’t do it well.

Joseph Wolfsdorf, MD, Associate Chief, Division of Endocrinology

 

Honoring different beliefs and cultures
Race and culture are sometimes challenging for us to work with, not just because of differences but because many different cultures have very different beliefs about food. So often, food is a way of showing your child and your family that you love them. For example, cooking favorite foods for a birthday celebration, or going out to eat at a favorite restaurant as a treat. It is so important to just work with these differences and honor different beliefs and make diabetes fit in with the culture of the family.

Jennifer Rein, LICSW, Licensed Social Worker

 

Coping with additional obstacles
Many of our families are from outside of the city, have traveled great distances to get here, have financial issues, or have struggled with mental health issues. Even if you have every asset in the world, diabetes is still hard. Having additional obstacles makes it just that much more challenging.

Jennifer Rein, LICSW, Licensed Social Worker


Seeing them happy
The most rewarding thing would have to be the obvious: seeing them happy and taking good care of themselves. Dealing with it, accepting the diagnosis, and being able to not let diabetes get in the way of their life.

Christina Luedke, MD, PhD, Physician

 

Building a relationship of trust
I love seeing the point when the child “gets it”. Another rewarding thing is that there is a before and after effect with blood checking. You get an outcome. If a child has gets good result from a blood check, its great watching that child be happy and smile about it. Building a relationship of trust with the parent and child is also a wonderful thing. They have to trust that you, as a clinician, care about the child and want to help–otherwise you wouldn’t be doing what you are doing.

Maryanne Quinn, MD, Physician

 

I learn something new every single day
I learn something new every single day, and usually it’s from a child, mother, or a father. Someone is always teaching me something. For example, I often meet with families during times of transition transitioning to the insulin pump, gaining more independence with diabetes care, moving on to college, or just working through a challenging time. While we’re sitting there together talking, the child usually shares so much valuable information. Together, the parents and I are learning from the child. It’s an amazing experience. Talking to kids about their experiences with diabetes or even talking to them about the challenges they face with diabetes is rewarding in many ways. Working together through some of the rough spots, you see a lot of growth, development, maturity and recognition that taking care of diabetes is a lot of work, but the overall goal is always to be a healthy adult and have a good life.

Jennifer Rein, LICSW, Licensed Social Worker