Serious conditions and complex health needs

Diabetes

There are 2 types of diabetes (types 1 and 2). We talk mostly about type 1 diabetes as this is the type which happens to children and young people. You can’t catch diabetes, it isn’t a bug, you ‘develop’ it. Type 1 diabetes happens when the body does not produce enough insulin. This means that glucose produced in the breakdown of food (digestion) stays in the blood.

If they are diagnosed, (their GP or a health professional has confirmed they have it), they may feel overwhelmed, angry, and worried about the future. They will now need insulin injections, or insulin using an insulin pump. A diabetes care team will help and support them, let them know they are not alone.

It's perfectly normal to have difficult feelings when they are diagnosed with diabetes. However, the condition doesn't have to take away their freedom, or end their usual family life, it just means they have to carefully manage their condition as part of daily life.

Early days

On diagnosis at the hospital, the specialist diabetes team will help and support them to manage their diabetes. Children and young people are cared for by a specialist diabetes team at the hospital. This team has:

  • A consultant paediatrician who specialises in diabetes.

  • Children and young person’s specialist diabetes nurses.

  • A dietician who is trained in the needs of children and young people.

  • A psychologist with a speciality in children and young people.

Soon they will be confident enough to take the first steps towards managing their diabetes. They will be in regular touch with their diabetes care team. The team keep in touch via clinics, some of which are in the evening as well as email and telephone. The specialist nurses can visit them at home and at school. They can also speak to their school nurse.

Signs and symptoms

Tell them to contact their GP urgently if they notice the signs below. If they cannot get an appointment the same day they need to attend a Walk-In Centre or A&E and explain their symptoms.

  • Feeling very thirsty and having a dry mouth.

  • Going to the toilet frequently, particularly at night.

  • Feeling very tired and drowsy.

  • Weight loss.

  • Signs that they could be seriously unwell - all of the above plus vomiting, abdominal pain and difficulty breathing.

Meningitis and Septicaemia

Meningitis and meningococcal septicaemia (blood poisoning) are serious diseases that can affect anyone at any time. Fortunately, most young people in the UK have already had the MenC vaccine, but if they haven’t or can’t remember, getting vaccinated is a good way to protect themself. But remember, vaccines can’t prevent all forms of meningitis and septicaemia.

What are the signs and symptoms?

Many of the early signs - vomiting, fever, aches, general tiredness and headaches - are also signs of less serious illnesses like colds and flu or even a hangover but someone with meningitis or septicaemia will become seriously ill in a matter of hours. Symptoms can appear in any order and not everyone gets all of the symptoms.

The main signs and symptoms of meningitis include: fever, very bad headache, vomiting, stiff neck, dislike of bright lights, rash, confusion, delirium, severe sleepiness, losing consciousness, seizures.

How is meningitis spread?

The bacteria that cause these diseases are spread by coughing, sneezing and intimate kissing. It can also be spread by sharing drinks. Outbreaks tend to occur where people live or work closely together, such as university halls of residence.

The glass test

Press the side of a glass firmly against the rash so they can see if it fades under pressure. If it doesn’t fade call 999 or go to A&E immediately.

If they are feeling very ill, get help anyway, even if the rash fades or doesn’t appear at all. It can be harder to see a rash on darker skin.

Students and young people will be offered a new Meningitis C vaccine. The Men ACWY vaccine is given by a single injection into the upper arm and protects against four different causes of meningitis and septicaemia. If they are going to college or university for the first time, contact their GP.

www.meningitisnow.org

Asthma

As they grow and develop as a young adult new opportunities and challenges come up every day. But what if they also have a life long condition, such as asthma, and are stepping out into the world for the first time on their own? If they are travelling, staying with friends or moving out make sure they are prepared.

From friends, family, partner, people at school or college there will always be certain people that they may feel awkward or nervous talking to them about their asthma. It’s their choice about who they choose to tell. Feelings of stress or anxiety can be a trigger for their asthma. Study can be stressful especially around exam time.

If they find it brings on their asthma tell them to speak to their GP/practice nurse and the welfare officer at their school, college or university to see what they can do to support them.

Everybody with asthma is different, and everybody deals with asthma differently. For most people, asthma shouldn't stop them enjoying everything in life, including relationships.

Taking medications as directed will help prevent long-term health problems. Stress to them they should always carry their relevant inhaler.

Things they may be asked

Have a think about the sorts of things people might ask them. For example:

  • What are your asthma symptoms? Everyone has different symptoms. For example, not everyone wheezes when they have an asthma attack.

  • What are your asthma triggers?

  • What are your asthma medicines and where do you keep them?

  • What should I do when you have an asthma attack? You might like to give them an asthma attack card to keep.

  • What does it feel like to have asthma?

Not everyone relates to hard facts so you could make it personal to you. Then you may find that people understand a lot better.

Do you have an asthma action plan?

If they use an asthma management plan they are four times less likely to have an attack that requires emergency hospital treatment. Fill this in with their GP/practice nurse. It will help them to know what medicine to take and when and how to recognise when their asthma symptoms change and what to do when this happens.

www.asthma.org.uk
Call 0300 222 5800 for independent, confidential advice from friendly asthma specialists.

Contacts

www.nhs.uk/Conditions
Young teenagers, sixth formers and ‘fresher' students going to university for the first time are advised to have a vaccination to prevent meningitis W disease.
www.nhs.uk/conditions/vaccinations/men-acwy-vaccine/

Meningitis Research Foundation
080 8800 3344
www.meningitis.org

Meningitis Now
080 8801 0388
www.meningitisnow.org

Asthma UK
Ask a Nurse Helpline 0300 222 5800
www.asthma.org.uk

The British Lung Foundation
03000 030 555
www.blf.org.uk/asthma

Diabetes UK
Careline 0345 123 2399
www.diabetes.org.uk

Type 2 Together Service
A new volunteerled approach to providing support, and learning about living with diabetes.
www.diabetes.org.uk/type-2-together

Black and Ethnic Minority Diabetes Association
www.bemda.org

National Children & Young People’s Diabetes Network
www.cypdiabetesnetwork.nhs.uk

Children with Diabetes in the UK
www.childrenwithdiabetesuk.org

school nurse
020 8661 3904

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