The challenge of transferring responsibility for diabetes management from parent to child.

To emancipate from their parents, children and adolescents with diabetes eventually must assume responsibility for self-care. The challenge that parents and health care professionals face is deciding when and how to transfer this responsibility from parent to child. Inappropriate transfer of self-care responsibility can precipitate poor metabolic control and strain parent-child relationships. By planning the gradual transfer of this responsibility based on children's cognitive abilities, maturity level, demonstrated self-care skills, and family environment factors, health care providers can minimize these problems.

Performance of seven blood glucose testing systems at high altitude.

Consumers and health care professionals expect blood glucose monitoring systems to consistently generate results that are close to actual blood glucose levels. Numerous environmental, physiologic, and operational factors can affect system performance, yielding results that are inaccurate or unpredictable. This study examined the effect of one factor--high altitude--on the performance of seven blood glucose monitoring systems. One of the systems overestimated blood glucose results; the other six systems underestimated blood glucose values (more than the expected variance). The findings of this study support previous reports of altered blood glucose monitoring system performance at high altitude. Diabetes educators can use this information when counseling consumers who reside or who plan to visit locations at high altitude.

Problems of mothers in management of children with diabetes.

This study was designed to determine which aspects of diabetic management were perceived by mothers of children with diabetes to be the most problematic. A secondary purpose was to explore how age and sex of the child, age at diagnosis, illness duration, marital status, and socioeconomic status of the mother were related to the mother's perception of problematic aspects of care. The 84 subjects in this study were asked to complete the Diabetic Management Concern Questionnaire, which measures concern about 11 dimensions of diabetes management, along with a personal-situational information sheet. Results indicated that the three dimensions classified by mothers as most problematic were future concerns, hypoglycemia, and diabetic control. The younger the child, the greater the maternal concern about hypoglycemic reactions and availability of help/support. The younger the child was at diagnosis, the more the mother was concerned with hypoglycemic reactions. A shorter duration of illness was related to concern about insulin injections. Subjects with lower socioeconomic status were concerned about finances, the availability of help/support, and the psychological stigma of diabetes. Single mothers were also concerned about financial aspects of management. There were no differences in concerns between mothers of boys and girls. Implications of the findings for clinical practice are presented.