Common Issues Seen in Paediatric Diabetes Clinics, Psychological Formulations, and Related Approaches to Management.

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Term Occurence Count Dictionary
Insulin 5 endocrinologydiseasesdrugs
diabetic ketoacidosis 1 endocrinologydiseases
hyperglycemia 5 endocrinologydiseases
hypoglycemia 12 endocrinologydiseases

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Select Drug Character Offset Drug Term Instance
Insulin 6819 also be a result of insulin omission and represents a serious problem in the adolescent or the family. Insulin omission may be a maladaptive coping strategy. This behavior can be used as a manipulative way to get
Insulin 9313 control [[16]].There are aspects of diabetes that may trigger the development of eating disorders. Insulin omission can be used to induce glycosuria leading to weight loss (case scenario II a) [[11]]. Initial
Insulin 13833 Scenario Discussion2.1.1. Scenario I a: A Male Adolescent Who Is Noncompliant with Glucose Monitoring and Insulin InjectionAli is a 16-year-old boy who was diagnosed with type 1 diabetes since the age of 8 years. He
Insulin 16665 metabolic control [[28]].2.2.3. Scenario I b: A School Child Who Inflicts Hypoglycemia by Repeated Insulin Injections to Be Offered Sweets/ChocolateAhmed is a 10-year-old bright boy who was diagnosed with diabetes
Insulin 23186 inflicting extra pressure on him.3. Eating Disorders3.1. Scenario II a: A Female Adolescent Who Is Skipping Insulin Fearing Weight GainSarah is a 15-year-old girl who has diabetes for the last 4 years. She is on multiple
Select Disease Character Offset Disease Term Instance
diabetic ketoacidosis 4992 requirements. Poor psychological support and defiant attitudes can lead to poor metabolic control and to diabetic ketoacidosis in some cases [[6]]. A study assessed 58 adolescents diagnosed with type 1 diabetes, and their parents
hyperglycemia 25968 Fatima extra snacks before bed to ensure blood glucose above 200 mg. This resulted in persistent hyperglycemia overnight and a high HbA1c. Her mother says, “it is better to have highs than lows.”4.2. How Would
hyperglycemia 26250 FormulationFatima's mother's behavior is probably resulting from anxiety over hypoglycemic episodes. Her “inducing hyperglycemia ” routine is an attempt to prevent hypoglycemia at nighttime. She is new to diabetes management and
hyperglycemia 26469 fear can be part of the adjustment process.4.2.2. ApproachCounselling her on the adverse effects of hyperglycemia resulting from such routine is necessary. It is important that the mother understands that giving routine
hyperglycemia 26619 necessary. It is important that the mother understands that giving routine snacks before bed will induce hyperglycemia and elevates the HbA1c. Educating the mother on the proper way of monitoring and preventing nocturnal
hyperglycemia 29376 with tasks, such as injecting insulin, testing blood glucose, supervising diet intake, and correcting hyperglycemia . Her twelve-year-old sister has repeatedly complained of the “extra care” their parents are giving
hypoglycemia 9703 restriction of favorable sweets can encourage extra insulin overdose to get the restrained sweet as a way of hypoglycemia correction (case scenario I b).1.9. Family DynamicsFamily function in relation to health management
hypoglycemia 17030 gone through a period of honeymoon which lasted around 4 months. His parents note that he has repeated hypoglycemia with marked reduction of insulin requirements. None of the hypoglycemia episodes has been reported to
hypoglycemia 17102 parents note that he has repeated hypoglycemia with marked reduction of insulin requirements. None of the hypoglycemia episodes has been reported to be due to injecting insulin then not eating the planned meal. Ahmed needed
hypoglycemia 17257 injecting insulin then not eating the planned meal. Ahmed needed treatment with sweets and juices for hypoglycemia on regular occasions. Doctors suspected self-inflicted hypoglycemia by taking extra insulin dosages
hypoglycemia 17325 treatment with sweets and juices for hypoglycemia on regular occasions. Doctors suspected self-inflicted hypoglycemia by taking extra insulin dosages and discussed with Ahmed who admitted this practice.2.3. How Would You
hypoglycemia 17586 FormulationAhmed's manipulation of diabetes care can be a way to overcome diabetes food restrictions. Inducing hypoglycemia might be an indication of the difficulty he has accepting diabetes care restrictions. It could also
hypoglycemia 18222 state of repulsion by Ahmed. The repulsion can then be expressed through manipulation and inflicting hypoglycemia which predispose him to self-harm.It is advisable that discussion with Ahmed and his parents be around
hypoglycemia 25832 parents coped with the diagnosis and managed Fatima very well, her mother remained scared of nocturnal hypoglycemia . Her routine was giving Fatima extra snacks before bed to ensure blood glucose above 200 mg. This
hypoglycemia 26300 anxiety over hypoglycemic episodes. Her “inducing hyperglycemia” routine is an attempt to prevent hypoglycemia at nighttime. She is new to diabetes management and her fear can be part of the adjustment process.4.2.2.
hypoglycemia 26735 and elevates the HbA1c. Educating the mother on the proper way of monitoring and preventing nocturnal hypoglycemia is most helpful, and reassuring her on the safety of the positive behavior is important. Achieving her
hypoglycemia 26916 behavior is important. Achieving her acceptance of the concept of the proper management of preventing hypoglycemia will eventually lead to improving behavior and adherence to the proper management.If resources are available,
hypoglycemia 27102 management.If resources are available, discussing continuous glucose monitoring devices equipped with hypoglycemia alarms might be beneficial in alleviating the anxiety and fear.4.3. Scenario III b: A Father with Diabetes

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