Beverly P. Giordano

Peer Group Support Program for Adolescents with Diabetes

a separate identity. The change from a dependent individual to an independent individual may be painful for both child and parent. During this developmental change, the adolescent behavior may range from cooperation to rebellion. 2-4 One intervention the health care professional can utilize in promoting a positive adaptation of the adolescent and family to diabetes is to urge them to realize that the adolescent is an in-

Factitious hypoglycemia: case report

In persons with diabetes, factitious disease may take the form of surreptitious insulin administration that causes unexplained hypo glycemia. Factitious disease is the desperate plea for help by a person who has been unable to devise a better solution for his or her emotional problems. This case report discusses a diabetic patient lost to factitious disease— in the hope that, in shar ing his story with other diabetes educators, some lives may be saved. A high index of suspicion should be maintained by the diabetes educator when he or she is asked to evaluate or reeducate a person with brittle diabetes or unexplained hypoglycemia.

The impact of genetic syndromes on children's growth

Genetic syndromes that include short stature are recognized by their effect on childrens growth rates, by their effect on the growth rate and pubertal development in adolescence, and by the presence of stigmata associated with certain syndromes. The effects of Down, Seckel, Turner, Russell-Silver, Prader-Willi, and Noonan syndromes on growth and the growth-inhibiting features of achondroplasia, hypophosphatemic rickets, and Laron dwarfism are reviewed. The terminology used by professionals in discussing genetic alterations should minimize the effects of labeling and stigmatization and should emphasize the normal aspects of a childs life.

A team approach to ... dietary problems of an adolescent.

The American Association of Diabetes Educa tors combines a diversity of professions and practices in its membership. To focus on the spe cial contributions of each discipline a common diabetes management or educational problem will be addressed periodically, using u team app roach.

a Team approach to

The American Association of Diabetes Educa tors combines a diversity of professions and practices in its membership. To focus on the spe cial contributions of each discipline a common diabetes management or educational problem will be addressed periodically, using u team app roach.

The Pregnant Diabetic

The American Association of Diabetes Educa tors combines a diversity of professions and practices in its membership. To focus on the spe cial contributions of each discipline a common diabetes management or educational problem will be addressed periodically, using a team ap proach.

Care of the Elderly

Case Description Mrs. M is an 80-year-old widow with diabetes mellitus, organic brain syndrome, arteriosclerosis, and osteoarthritis. She was placed in a nursing home three years ago because she was unable to care for herself and her children could not provide her with the supervision and care that she needed. Over the past six months, Mrs. M has had a weight gain of ten pounds and required both a gradual increase in her in-