Wafaa 10/08

NEW DX D.M. I -- COUNSEL FATHER

9 yo male, dx with DM I. Father here

T Explain condition
Consel him and answer his Q.

Do u know abt this condition

In this condition the level of the glucose in blood os more than N. There are 2 types I & II
In I theres a lack of Insulin, it’s v common in young children in age group on
II Insulin is present but not functioning properly usually found in age and who r obese.
Symptoms that can happen. They can loose wt, feel tired, fatigue, bed wetting, thristy, sweaty, prone to
infxn, the N level of glucose in fasting should be less than 6 and in DM is > 7.
Now there are v good treatment. With Insulin. Is given as an injection. There will be regular spaced
healthy meals, are imp; and b4 every meal Insulin injection is given without fail
I’ll refer u to dietitian to give u a complete chart of the food to b eaten and avoided. Glycemic Index
chart. Exercise is imp as well.
Inj is usually given in the tummy, pinch the skin of tummy and insert needle strainght in after
withdrawing the needle press down firmly for 30 sec. Do not rub or massage .
The nurse can repeat to u later now.
Right now is difficult to David to inject, but later on he will be able to inject by himself. Nowadays this
injections r not painful
The BSL need to be regularly checked by a glucometer. Check it 4 t/ day. Once his level is stable, u can
decrease checking to 1/day.
Good to keep a diary and keep the level, b4 every meal.
You need to know a complicat that can happen. Hglyc this can happen if given too much insulin
Sympt hungry sweaty, he can even loose cons, give him sweet by mouth like jelly beans followed by
snack. If this is not helping bring him to hosp they’ll give 1 ml glucagon IM or 10 ml 50% dextrose IV
Another condition to kkep in mind is DKA : N&V drowsiness, fast breathing, tummy pain; its v serious
come to hosp immediately. They’ll give 10 U of rapid acting Insulin IM + NaCl 0.9%

I’ll give u hand outs

It’s good to teach family members how to inject and teach them sign and sympt.
It’s also a good idea to give these handouts to school so they know

It’s a multidiscipli
Family. GP dietitian, DM special, DM nurse, counseler, t4acher, join the DM organization
Support counseling info
It’s also good to buy a bracelet and make him wear it with the condition
When ever u go to the doctor or chem. Tell tehm he is on I
I know this is a lot to know now, we’ll go step by step, feel free to come and see us if any doubts

Introduction:

I can see that you are worried about your son’s condition
Do you now about this condition?
In this condition the level of glucose in the body is >than normal
In type I there is lack of insulin, it is very common in young children (10years – 30years)
Type II the insulin is present but not functioning properly usually in people >40 yrs old or obesity

The symptom can happen:

1. lose weight
2. tired/ fatigue
3. feel thirsty
4. bed wetting
5. sweaty
6. prone to infection

The normal level of glucose in fasting should <6 in DM it is >7

Rx: insulin injection
Insulin is given as injection
There will be regular spaced healthy meals are important and before every meal insulin injection is given
without fail. I will refer you to dietician to give you a complete chart of the food that he can eat
(Glycaemic chart)

It is healthy for him to exercise

Injection is usually given in the tummy, pinch the skin of the tummy and insert the needle. After
withdrawing the needle, press down firmly (30secs), don’t rub or massage.

The nurse will teach again.

Because of his age, right now it is difficult for david to inject himself.

Nowadays, injections don’t give any pain

As he will take insulin before every meal or before sleep, the glucose level needs to be checked as well
with a glucometer
Check his glucose level 4x/day
And once his level is stable – you need to check only once a day

It is good to keep a diary to keep the reading levels

Complication: hypoglycaemia – this can happen when a high dose of insulin is given or when he does
not consume enough food

Symptoms: hungry, shaky, sweaty sometimes loss of consciousness

Give sweets by mouth like jelly beans and followed by a snack
If no effect pls take him to hospital
IM 1 ml glucagon or IV 10ml 50% dextrose

DKA: This is another condition if insulin is not given

Symptoms: drowsy, fast breathing, nausea and vomiting, tummy pain

This is a very serious condition. Please come to the hospital

IM 10 units of rapid acting insulit

I will also give you hand outs about DM and its complications. It is a good thing to teach your family
members about DM

This is going to be a multidisciplinary approach: Family, GP, Dietician, DM specialist, diabetes nurse,
teachers, counselors

You can join DM organization or support for counseling information

It is also good if you can get a bracelet with the condition and make him wear it

When you go to the pharmacy or another doctor. Please let them know about his condition.