No abstract

The hypothesis that negative affectivity (NA) is associated with accuracy of blood glucose (BG) symptom perceptions and diabetes control was assessed. After completing measures of BG symptom beliefs and NA-related constructs (i.e., attentional focus and trait anxiety), 35 adolescents with insulin-dependent diabetes monitored their physical symptoms and their actual BG levels 3 times daily for 2 weeks. Each subject's actual BG symptoms were determined by correlating symptom ratings with BG levels and were then compared with symptom beliefs. Those who were more internally focused were more able to discern which symptoms actually covaried with BG fluctuations; those with higher trait anxiety tended to misattribute non-diabetes-related symptoms to BG levels. Finally, interactions suggested that those who both attend to internal physical sensations and experience-heightened anxiety display poorer metabolic control.

A program to teach parents how to instruct elementary school teachers about children with diabetes mellitus was evaluated using a 14-point questionnaire prior to intervention and 6 to 8 weeks after intervention. There was a significant improvement in many aspects of the teacher's knowledge of diabetes, although a few basic concepts remained unclear. We feel that refining the presentation and repeating the program as teachers encounter more children with diabetes will provide effective basic diabetes education to the elementary school teacher.The child with diabetes frequently must rely on the elementary school teacher for assistance. The teacher must be able to recognize and respond to hypoglycemia, help with decisions about eating and exercise, and understand when a child is ill and needs further medical aid. Because most young elementary school students are unable to care for themselves entirely, the teacher's ability to deal with diabetes-related issues becomes critical.Several studies'-' have shown that the average schoolteacher knows little about childhood diabetes. A previous attempt4 at educating entire school staffs about diabetes proved largely unsuccessful. The approach was found to be excessively time-consuming, and many major misconceptions persisted. Consequently, school staffs were no better prepared to handle emergencies. In this study, we attempted a different approachtraining parents to effectively educate their own children's teachers. MethodsForty-nine families were invited to participate because of their proximity to our center and because of their expressed interest in educating their child's teacher. These families attended a 2-hour seminar in which they received advice on how to educate the teachers. During a didactic presentation, they learned methods for teaching about basic physiology and the treatment of childhood diabetes. The presentation emphasized recognizing and responding to hypoglycemia, and the symptoms of hyperglycemia. The importance of dietary management and appropriate preparation for unusual exercise also were reviewed. They observed a role-playing session by a social worker and nurse educator, illustrating ways to best present this information and to answer teachers' questions and concerns. Families were given a handout (Figure) containing information about insulin-dependent diabetes mellitus to help organize their thoughts while talking to the teachers. The outline ensured that they would discuss diet, exercise, hyperglycemia, hypoglycemia, and the unique diabetic characteristics of their child. Parents also were given several articles on &dquo;what to tell the teacher&dquo; to enhance their knowledge and to use as supplemental information as they visited with the teacher.5-8 Finally, pamphlets from the at MOUNT ALLISON UNIV on June 15, 2015 tde.sagepub.com Downloaded from

The effects of a high-carbohydrate, high-fiber (HCHF) diet on glucose control was evaluated in 12 children with type I diabetes mellitus. The children had had diabetes for an average of 5.25 yr; their mean glycosylated hemoglobin was 12.4% (normal 5-9%), and C-peptide was virtually undetectable in all but one. They were followed on a regular diabetic diet for 10 days at home and in the hospital and then were studied on a HCHF diet for 14 days. The HCHF diet contained 60% carbohydrate and 30 g of fiber per 1000 cal provided through grains, fruits, vegetables, and high-fiber crackers. Capillary blood glucose levels were monitored at home before meals and at bedtime, and venous plasma glucose levels were measured in the hospital before and after each meal and during the night. Plasma glucose was measured serially after test meals with each diet. There was no significant difference in blood glucose levels preprandially, postprandially, and while fasting on the two diets. The 24-h glucose profiles and posttest meal profiles obtained during both diets were remarkably similar. We conclude that a diet high in fiber and carbohydrate has limited application in children with type I diabetes mellitus who have no residual beta-cell function.