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Who Is the Customer?

Jay¹, Morse, Rickert

¹UTMB Dept. OB/GYN, 301 University Blvd., Galveston, TX 77555-0587, USA.

Adolescent Medicine (Philadelphia, Pa.)

|October 1, 1996

Summary

This case study highlights a 14-year-old with type 1 diabetes mellitus experiencing weight gain. Management focused on a collaborative exercise and eating plan involving the adolescent and her parents.

Area of Science:

Pediatric Endocrinology
Metabolic Disorders
Adolescent Health

Background:

Type 1 diabetes mellitus (T1DM) requires lifelong management, often involving family participation.
Adolescence is a critical period for T1DM management, with potential for metabolic changes like weight gain.
Parental involvement is crucial but can sometimes create complex dynamics in treatment decision-making.

Purpose of the Study:

To describe a clinical case of adolescent T1DM with significant weight gain.
To explore the challenges in managing T1DM when parental concerns about weight overshadow glycemic control.
To illustrate a therapeutic approach balancing adolescent autonomy with parental support in T1DM care.

Main Methods:

Case report detailing a 14-year-old female diagnosed with T1DM at age 6.

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Assessment of anthropometric data, including height (174.2 cm) and weight (73.9 kg), indicating a recent 5.8 kg gain.

Clinical observation of differing concerns between the adolescent and her parents regarding weight versus blood sugar levels.

Main Results:

The adolescent presented with recent, notable weight gain.
A discrepancy existed in the primary concern between the patient (moderate weight gain concern) and parents (high weight concern, low blood sugar concern).
Parental objection to separate interviews highlighted the need to identify the primary treatment requester.

Conclusions:

Effective T1DM management in adolescents requires addressing both metabolic control and psychosocial factors, including weight management.
A nuanced approach is necessary when parental priorities differ from the adolescent's, ensuring collaborative care.
Recommending a structured exercise and eating regimen with parental support facilitated a balanced management strategy.