They must be recognized and attended to just as the medical aspects. The emotional management many be divided into preventive care and intervention . Preventative mental health care begins with all family members consulting a mental health expert at the time of diagnosis with periodic but regular follow-up. The purpose of follow-up is to curtail problems, increase communication, and monitor the emotional progress of the family members. Just as the diabetologist evaluates the progress of the diabetic and recommends changes in management, the mental health expert functions similarly.
Intervention represents a more intense focus when significant issues arise.
These may include non-compliance, significant arguments between diabetic and parents revolving around diabetic care, problems with the diabetic achieving appropriate independence, and mood changes in any family members. It must be emphasized that a proper plan for addressing the complex emotional issues must be part of the health care planning for the juvenile diabetic and his family. The diabetologist is an excellent resource to formulate such a plan. The emotional as well as the physical prognosis will improve when a preventative and intervention model is included in a treatment plan. Dr. Bruce P. Pfeffer is Assistant Clinical Professor, Department of Psychiatry at Georgetown University Medical School.