ISPAD Clinical Practice Consensus Guidelines 2018: Diabetes education in children and adolescents.

RECOMMENDATIONS/EXECUTIVE SUMMARY Education is the key to successful management of diabetes [E]. To maximize the effectiveness of diabetes treatment and the advances in diabetes management and technology (especially insulin pumps and continuous glucose monitoring) it is advisable that quality assured structured education is available to all young people with diabetes and their carers [E]. The content and delivery of structured education needs regular review to ensure it suits the needs of people with diabetes in that community, matches local practice, and reflects changes in diabetes management and technology [E]. Evaluation of structured educational programs should include measurement of outcomes directly related to diabetes education such as the patient\u27s achievement of self‐selected diabetes‐care goals, improved psychosocial adaptation and enhanced self‐efficacy, in addition to measures of glycemic control [E]. There is evidence that educational interventions in childhood and adolescent diabetes have a beneficial effect on glycemic and psychosocial outcomes [A]. Educational interventions shown to be effective include those: based on clear theoretical psychoeducational principles [E] integrated into routine clinical care (eg, as an essential integral part of intensive insulin management) [A] referred to as an ongoing process of provision of individualized self‐management and psychosocial support [E] involving the continuing responsibility of parents and other carers throughout adolescence [B] making use of cognitive behavioral techniques most often related to problem solving, goal setting, communication skills, motivational interviewing, family conflict resolution, coping skills, and stress management [A] utilizing new technologies in diabetes care as one of the vehicles for educational motivation [A] Health care professionals require appropriate specialized training in the principles and practice of teaching and education to implement successfully behavioral approaches to education designed to empower young people and carers in promoting self‐management [E]. An interdisciplinary education team sharing the same philosophy and goals and speaking “with one voice” has beneficial effects on metabolic and psychosocial outcomes [B]. It is important that goals and targets for blood glucose and HbA1c align with those of ISPAD. A major task during the first 2 weeks after diagnosis of diabetes is to get the family to agree to encompass the same targets. [E] Mobile and web‐based applications can be useful tools for diabetes self‐management education to improve diabetes management. [E] Interactive web‐based educational resources designed by diabetes‐related device manufacturing companies are widely used for device‐specific patient training and education. [E] Telemedicine, if available, offers an alternative method to face‐to‐face diabetes review for people who live in remote areas and do not have access to professional counseling and diabetes education resources locally. [B] Diabetes peers and/or diabetes youth leaders can reinforce the principles of living well with diabetes and support the families learning especially in the resource limited setting. [E