Transitions in Care. Howard A. Wolpert

      

      Transitions

       in Care

      Meeting the Challenges

       of Type I Diabetes

       in Young Adults

      

Howard A. Wolpert, MD Barbara J. Anderson, PhD Jill Weissberg-Benchell, PhD, CDE

      Director, Book Publishing, Robert Anthony; Managing Editor, Abe Ogden; Acquisitions Editor, Professional Books, Victor Van Beuren; Editor, Wendy M. Martin; Production Manager, Melissa Sprott; Composition, Circle Graphics; Cover Design, Koncept, Inc.; Printer, Victor Graphics.

      ©2009 by the American Diabetes Association, Inc. All Rights Reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including duplication, recording, or any information storage and retrieval system, without the prior written permission of the American Diabetes Association.

      Printed in the United States of America

      1 3 5 7 9 10 8 6 4 2

      The suggestions and information contained in this publication are generally consistent with the Clinical Practice Recommendations and other policies of the American Diabetes Association, but they do not represent the policy or position of the Association or any of its boards or committees. Reasonable steps have been taken to ensure the accuracy of the information presented. However, the American Diabetes Association cannot ensure the safety or efficacy of any product or service described in this publication. Individuals are advised to consult a physician or other appropriate health care professional before undertaking any diet or exercise program or taking any medication referred to in this publication. Professionals must use and apply their own professional judgment, experience, and training and should not rely solely on the information contained in this publication before prescribing any diet, exercise, or medication. The American Diabetes Association—its officers, directors, employees, volunteers, and members—assumes no responsibility or liability for personal or other injury, loss, or damage that may result from the suggestions or information in this publication.

      

The paper in this publication meets the requirements of the ANSI Standard Z39.48-1992 (permanence of paper).

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      American Diabetes Association

      1701 North Beauregard Street

      Alexandria, Virginia 22311

      DOI: 10.2337/9781580403641

       Library of Congress Cataloging-in-Publication Data

      Wolpert, Howard, 1958-

       Transitions in care : a guide on the challenges of type 1 diabetes in the young adult period for patients, their families, and health care providers / Howard A. Wolpert, Barbara J. Anderson, Jill Weissberg-Benchell.

       p.; cm.

       Includes bibliographical references and index.

       ISBN 978-1-58040-324-5 (alk. paper)

      I. Diabetes in youth. 2. Diabetes in adolescence. I. Anderson, Barbara J. (Barbara Jane), 1947-II. Weissberg-Benchell, Jill. III. American Diabetes Association. IV. Title.

       [DNLM: 1. Diabetes Mellitus, Type 1. 2. Young Adult. 3. Adolescent. WK 810 W866ta 2009]

      RJ420.D5W65 2009

       616.4′6200835--dc22

      2008050822

      eISBN: 978-1-58040-364-1

      Contents

       PRELUDE: WHY WE WROTE THIS BOOK

       I

       The Challenges of Young Adulthood

       Developmental Issues in the Young Adult (Emerging Adulthood)

       The First Phase of the Young Adult Period

       The Second Phase of the Young Adult Period

       II

       Getting Prepared for Your Journey with Diabetes through Young Adulthood

       You Don’t Need a Sermon, But the Basics Won’t Hurt

       Understanding Insulin Replacement

       Approaches to Insulin Treatment

       Deciding Which Insulin Program Is Right for You

       Fundamental Skills in Managing Diabetes

       Keeping Perspective About Monitoring and Numbers

       Bumps in the Journey: Intensive Therapy and Hypoglycemia

       Will Real-time Continuous Glucose Monitoring Help Me?

       More Bumps in the Journey: Intensive Therapy and Weight Gain

       Some Advice for Your Journey

       Problem Areas in Diabetes (PAID) Questionnaire

       Preventing Complications

       Relationships and Explaining Diabetes to Your Significant Other and Friends

       Changing Ties with Your Family

       Learning How to Be an Effective Patient

      Health Insurance Issues

       Pregnancy

       Smoking

       Alcohol

      Getting Physical

       III