Reflections on Incorporating a Behavioral Intervention into a Busy Pediatric Subspecialty Clinic

Pediatric diabetes is a condition that requires a tremendous amount of self-care and investment on the part of patients and families. It involves checking blood glucose values multiple times per day, counting carbohydrates, calculating insulin doses, and taking an insulin injection (or pump bolus) with every meal. It is not uncommon for patients to feel burned out and decrease the intensity of their diabetes care, particularly during the teenage years (Hood et al., 2014). There are many reasons why this can occur—for example, lack of acceptance of diagnosis, fatigue with the process and work involved, feeling discouraged because of erratic blood glucose levels despite good effort, or simply not wanting to be told what to do as an adolescent.

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