Role of nurses in education of parents of children with newly diagnosed type 1 diabetes mellitus

Diabetes mellitus složeni je metabolički poremećaj praćen dugotrajnom povišenom razinom glukoze u krvi zbog nedostatnog izlučivanja inzulina, odnosno njegova smanjenog djelovanja ili potpunog izostanka djelovanja. To dovodi do poremećaja u metabolizmu ugljikohidrata, masti i bjelančevina, povećanja količine glukoze u krvi i gladovanja stanica u tijelu. Osnovno obilježje dijabetesa u djece jest njegova ovisnost o inzulinu, odnosno nužnost inzulinske terapije i to ne samo za kontrolu bolesti već i za samo preživljenje. Dijabetes počinje tako da u genetski sklonih osoba dolazi do autoimune upale i postupnog uništavanja beta-stanica gušterače, a cijeli je proces potaknut nekim od utjecaja iz okoline, od kojih se najčešće spominju virusi, toksini, lijekovi, sastojci hrane i stres. Dijabetes mellitus tip 1jedna je od najčešćih kroničnih bolesti u dječjoj dobi čija incidencija raste, posebice u mlađim dobnim skupinama. Od oko 440.000 djece koja boluju od dijabetesa tip 1 u svijetu, petina ih živi u Europi. Incidencija dijabetesa u Hrvatskoj iznosi gotovo 10 na 100.000 djece/godinu te se u skladu s opisanim trendovima u Europi i u nas prati porast incidencije, posebice u mlađim dobnim skupinama. Osnova dobre kontrole glukoze u krvi, odnosno same bolesti, jest edukacija roditelja i djece. Proces edukacije od strane medicinske sestre započinje već pri prvoj hospitalizaciji djeteta zbog novootkrivenog dijabetesa. Edukacija se nastavlja trajno, prilagođena je dobi djeteta i mijenja se s odrastanjem. Osim edukacije o provođenju dnevne terapije i pravilne prehrane, od velike je važnosti što bolje emocionalno prilagođavanje cijele obitelji na novootkrivenu bolest. Od roditelja se očekuje aktivan pristup, svakodnevno praćenje samokontrole i donošenje odluka što nije nimalo lako. Rezultat kvalitetnog pristupa medicinske sestre oboljelom djetetu i njegovoj obitelji jest dobro educiran roditelj i dijete, jaka motiviranost i iznimno dobra komunikacija s dijabetološkim timom. Medicinska sestra kao član zdravstvenog tima i edukator ima značajnu ulogu u liječenju bolesti jer upravo o edukaciji ovisi kako će se roditelji, a i djeca, nositi s tom bolešću te kakva će biti njihova kvaliteta života.Diabetes mellitus is a complex metabolic disorder accompanied by prolonged elevated blood glucose levels due to insufficient secretion of insulin, i.e. its reduced function or complete absence of action. This results in metabolism disorders of carbohydrates, fats and protein, increased blood glucose levels, and cellular fatigue in the body. The basic feature of diabetes in children is its insulin dependency - the need for insulin therapy, not only for the control of the disease, but also for survival. Diabetes begins by causing autoimmune inflammation and the gradual destruction of pancreatic beta-cells in genetically prone individuals, and the whole process is triggered by some effects from the environment, most commonly mentioned are viruses, toxins, drugs, food ingredients and stress. Diabetes type 1is one of the most common chronic diseases in children whose incidence is increasing, especially in younger age groups. Of about 440,000 children suffering from Type 1 diabetes worldwide, the fifth lives in Europe. The incidence of diabetes in Croatia is almost 10 per 100,000 children per year, and according to the trends described in Europe and in the United States, there is an increase in incidence, especially in younger age groups. The education of parents and children is the foundation for good blood glucose control and the disease itself. The nurses' education process begins with the first hospitalization of a child due to newly discovered diabetes. Education continues on a permanent basis, adapts to the age of the child and changes as the child grows up. In addition to training on day-care and proper nutrition, it is of great importance to improve the emotional adaptation of the whole family to the newly discovered disease. Parents are expected to have an active approach, day-to-day self-control and decision-making, which is not easy at all. The result of a quality approach of a nurse to a child and his / her family is a well-educated parent and child, strong motivation and excellent communication with the diabetes team. A nurse as a member of a health team and as an educator plays a significant role in treating the disease because the way the parents and the child deal with the disease depends on their education about the disease and therefore influences the quality of their life