Diabetes Self-Management Articles

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Diabetes Support at School
Starting a Group

by Debra Madaris Efird

Initial session
At the first session, the group leader can begin by covering general information about the support group. Rules are necessary but should be few in number. Some acceptable rules are listening respectfully to others, not monopolizing the discussion, and only laughing with someone as opposed to laughing at him. The importance of confidentiality should be explained. It is a good idea to go over the schedule thoroughly, ensuring that the students understand proper procedures for leaving and reentering classes. Placing reminder notes in teachers’ mailboxes on the days of group meetings may be essential for students to show up without being chased down. Yes, they want to be with the group, but it’s amazing how often adolescents can forget.

After the leader has covered the basics, the group can move on to a great conversation starter: a sentence-completion activity. Before the meeting, the leader should write unfinished sentences about diabetes on a piece of paper, cut the paper into strips so there’s one sentence per strip, and place the strips in a basket. When the group is ready, pass the basket and have each child draw a strip. Students should be allowed to pass or redraw if they do not feel comfortable finishing the sentence on their slip. Here are some examples of what to write:

  • I want to tell my friends who don’t have diabetes that…
  • When I see my parents upset about my diabetes, I feel…

It is important to take as much time as needed for this activity, allowing students to elaborate on their own statements and those of others. They may be new to each other and a bit timid at this first session. At first the older students may tend to dominate the younger ones, and the leader will need to take over the reins if this happens.

Challenge of the day
Starting with the second session, it may be desirable to begin each meeting with a “challenge of the day.” This can be related to the meeting’s main topic or tied to the season. A timely issue to discuss in October is Halloween: how students handle the candy bombardment. They may give answers such as, “My dad buys my candy from me by the piece, so I make a lot of money!” “I have fun dressing up and handing it out at the door,” or, “I like to give it to my friends.”

Other possible “challenge of the day” topics are field trips, swimming pool events, sleepovers, and even something as general as the amount of time spent each day checking blood glucose levels.

School life
An ideal main focus for one of your meetings is how having diabetes affects school life. After all, school is of supreme importance to adolescents; they will have a lot to say. The leader should make sure group members understand their right to check blood glucose levels at school and to see the nurse any time they need to. They can be asked how they feel about having to miss part of class to check in with the nurse. How do they catch up in class? How do episodes of high or low blood glucose affect their grades? What are the pros and cons of being separated from others or having other modifications during standardized tests? What worries them most about school?

Food scenarios
Another good topic for the group to discuss is how food is at the center of many school (and other) events, and how to deal with these situations in a healthy manner. The group leader can distribute a worksheet that describes typical situations teens find themselves in during or after school hours, with options for how to act in each situation. Students should select the best choice for each (and maybe also note how they probably would really act). The group can do this together, with the leader asking who chose A, B, C, or D. Students can share an additional answer (E?) if they think of an alternative solution. Here’s an example:

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