Diabetes Self-Management Articles

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Diabetes Support at School
Starting a Group

by Debra Madaris Efird

Jonathan’s chess club always has snacks during the meeting. Students take turns providing refreshments, and most bring regular sodas and high-calorie sweets. Jonathan should (A) eat nothing and sulk, (B) eat some of it if he’s hungry and cover the carbohydrate he consumes with insulin, (C) bring his own snacks, or (D) when it’s his turn, bring in healthy snacks.

Home life
At another session, the group can talk about how having diabetes affects their lives at home. To stimulate discussion, the leader should write the word “activities” on half a dozen narrow strips of the same color of paper, the word “siblings” on six more, and the words “food” and “money” on six more each, as well. A different color should be used for each category. With all of the strips in a basket, each student must then draw a strip and tell how having diabetes affects that particular aspect of his home life. For example, if a student pulls a strip labeled “money,” he should describe an incident or something in general about how his diabetes affects family finances. He may reveal that he has overheard his mother complain about the cost of insulin, or that his family is saving money for a pump.

To raise the chances that all the different topics will get discussed, the leader should not tell students during the first round that the colors of the strips mean anything. After the first round, however, students can be told that all yellow strips are about money, all blue ones are about food, etc. Then in subsequent rounds they can exercise choice in selecting the area they want to discuss. With the strip labeled “food,” students may talk about not always being able to eat what everyone else in the family is having for dinner, or about the trouble their mothers go to just to cook something special for them. With the strip labeled “activities,” there may be responses about the whole family canceling plans when the student has an episode of low blood glucose. The strip labeled “siblings” can be expected to stir up some anger: Students may report on siblings who taunt them while snacking on candy bars or who scream in jealousy over all the attention the sibling with diabetes gets. This activity sparks both laughter and shared frustration, and helps bond the students even closer.

“Live-abetes”
For the January session of the group, I suggest not talking about diabetes. The leader should place a sign on the door of the room that says “Live-abetes” and tell the students they cannot utter the word “diabetes” during the entire session. If someone says the “d” word, there can be a silly punishment, like running a lap around the table or singing a solo.

Since January is a time of beginnings, this session will emphasize the value of focusing on the many other aspects of life. The students can do this by making a collage. For this, the group leader should cut out magazine pictures ahead of time and lay them out on a table. Students can then select pictures that they think represent them both now and how they’d like to be in the future. Once they have completed their collages, each should share the reasons for his choice of pictures. At the end of the year, when the students complete evaluation forms, many may choose this session as their favorite — they are given permission to see themselves, and encourage others to see them, as someone other than “that diabetic kid.”

Advances in medicine
At another session, the group leader may want to talk about what is on the horizon in the medical field; it’s hard to talk about diabetes without mentioning the research that brings hope to so many. A reputable Web site such as the American Diabetes Association (www.diabetes.org) or the Juvenile Diabetes Research Foundation International (www.jdrf.org) can provide appropriate information to share. It is a good idea to caution the students about claims of cures, assuring them that their doctors will know when something helpful has been approved. Let them imagine some funny cures, and they’ll laugh themselves silly. What if doctors find out that green M&M’s are the magic bullet? What if a mixture of chopped caterpillars and birdseed is the cure — would you eat it?

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