DSME content based on life stages
Infancy (birth–18 months) |
Period of trust versus mistrust |
Providing warmth and comfort measures after invasive procedures is important |
Feeding and sleeping or nap routines |
Vigilance for hypoglycemia |
Play age (3–5 years) |
Reassurance that body is intact, use of Band-Aids and kisses after procedures |
Identification of hypoglycemic signs and symptoms (temper tantrums and nightmares are common) |
Include child in choosing injection and finger-prick sites |
Positive reinforcement for cooperation |
Begin process for teaching child awareness of hypoglycemia |
School age (6–12 years) |
Integrate child into educational experience |
Determine skill level |
Identify self-care skills |
Determine roles and responsibilities |
Communication with peers and school staff—who and when to tell about diabetes |
Adolescence (12–18 years) |
Begin transition care planning |
Personal meaning of diabetes |
Determine roles and responsibilities in care |
Social situations and dating |
Who or when to tell about diabetes |
Driving |
Sex and preconception counseling |
Alcohol and drugs |
College and career planning |
Young adults |
Personal meaning of diabetes |
Roles and responsibilities in care |
Social situations and dating |
Who or when to tell about diabetes |
Genetic risks, conception, and preconception |
Travel |
Choosing or pursuing a career |
Workplace rights |
Health or life insurance |
Involving friends and significant others in diabetes care |
Safety |
Creating a support network |
Establishing or maintaining independence |
Middle-aged adults |
Personal meaning of diabetes |
Roles and responsibilities in care |
Involving spouse or significant other in care |
Sexual functioning |
Developing a support network |
Travel |
Pursuing a career |
Workplace rights |
Health or life insurance |
Talking with children or other family members about diabetes |
Balancing other responsibilities with diabetes care |
Safety |
Facing complications |
Older adults |
Personal meaning of diabetes |
Roles and responsibilities in care |
Maintaining independence |
Obtaining assistance with diabetes care tasks |
Involving spouse or significant other in care |
Travel |
Talking with adult children or other family members about diabetes |
Safety |
Assessing for declines in ability to perform self-care/activities of daily living |
Caring for diabetes along with other chronic illnesses or comorbidities |
Obtaining health care when living in multiple locations |
Community resources |
Care of type 1 diabetes in long-term or other care facilities |