Children's Adaptation to Insulin Dependent Diabetes Mellitus: a Critical Review of the Literature

A preventive health care context is important in managing children with insulin dependent diabetes mellitus (IDDM). Specific risk factors can make adaptation to IDDM more difficult. These include older age, female gender, family stress, and non-intact family structure. Factors which enhance child adaptation, also called resistance factors, include family cohesion and adaptability, positive coping strategies, younger age, and social support. Children having a chronic illness face many challenges, including changes in lifestyle, such as regimented scheduling of everyday life, readjustment of roles in the family, and potential activity alterations. An important role of health care professionals is to guide and counsel both children who are newly diagnosed with a chronic illness and their families about ways to normalize their lives as much as possible, even while realizing that their lives will never be the same as before diagnosis. Throughout the course of an illness, children and families rely on nurses to provide information about health promotion and illness management. Nurses coordinating the care of children adapting to insulin dependent diabetes mellitus (IDDM) must recognize the significance the diagnosis has on the child. Furthermore, identification of those factors that place the child at risk for poor adaptation is critical so that the nurse can assist with the process of adaptation and recruit other psychological or social support resources as early as possible.