Children and adolescents with diabetes.

IDDM in children and adolescents requires that complex daily management skills be learned by children and their families. Insulin administration, nutrition therapy, and daily monitoring place the burden of self-management on parents and children, who already may be stressed. The unrelenting care required to observe and treat young children produces anxiety in parents whose children are potentially poised between hypoglycemia and DKA. Health care professionals must understand the dynamic nature of childhood diabetes and not underestimate the impact on specific developmental levels or the amount of support and education required.