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Noticias Actualizadas sobre COVID-19 (Coronavirus)

La crisis de COVID-19 ha traído consigo grandes retos para todos, incluyendo a los niños con diabetes tipo 1 (DT1) y a sus familias. A continuación, hemos recopilado consejos sobre salud mental durante esta crisis, consejos para mantener a sus hijos saludables e informados durante este tiempo en que, por orden del estado de Michigan, todos estamos confinados a nuestros hogares. Puede usar los ‘links’ que se encuentran en la parte de arriba de este documento para encontrar información sobre los temas indicados.

Consulte esta página para estar informado sobre las recomendaciones y consejos más actualizados según se desarrolla la situación del COVID.

Apreciamos su paciencia y fortaleza en este momento histórico y queremos asegurarle a todos nuestros pacientes y a sus familias que no están solos.  Durante este tiempo tan difícil, la Clínica de Diabetes Pediátrica de la Universidad de Michigan continúa con su compromiso de ofrecer el cuidado médico que sea necesario para su niño o joven adolescente con DT1.

Consejos para la salud mental

La situación de COVID-19, el "distanciamiento social" y la orden del estado de Michigan de permanecer en nuestros hogares han traído nuevos retos para todos, incluyendo a los niños y a los jóvenes adolescentes con DT1.  Si su familia está experimentando un "Burnout “o “desgaste” asociado al cuidado que se necesita para atender los quehaceres diarios de la diabetes, le recomendamos que lea nuestros consejos sobre cómo superar el estrés (Overcoming Stress with T1D). También le recomendamos los consejos que leerán a continuación. Si usted o un ser querido está deprimido o tiene señales de tener ‘síndrome de desgaste (síndrome de Burnout) severo, llame a nuestra Clínica de Diabetes Pediátrica de la Universidad de Michigan (calling the clinic) para hablar con nuestro equipo de psicológia.  También animamos a que los padres visiten el sitio web de Zero to Thrive (Zero to Thrive's website) para obtener información útil sobre cómo explicarles la situación del coronavirus a los niños más pequeños en su hogar.

Aumentando el distanciamiento social sin disminuir su estado de ánimo

Los niños y jóvenes adolescentes necesitan interacción social y actividades para su desarrollo. El propósito de la orden de distanciamiento social es limitar las interacciones de grupos grandes de personas, para no encontrarnos con individuos potencialmente enfermos, o con aquellos que estén infectados sin tener síntomas obvios. Si bien muchas de las actividades que disfrutamos están limitadas en estos momentos, podemos ser creativos y producir actividades que promuevan un estado de ánimo positivo. Aquí compartimos algunas ideas:

  • Usar la tecnología sabiamente:  Considere ajustar el limite de tiempo que los niños pasan frente a una pantalla (TV, video juegos, computadoras) para dejar que interactúen más con sus compañeros/as a través de las tecnologías de comunicación. Además, considere usar  “chat” de video para conectarse con sus familiares y amigos adultos que puedan estar aislados socialmente. Los abuelos pueden disfrutar pasar el tiempo haciendo artes manuales con los más pequeños, o leer libros juntos. ¡Se benefician y se divierten todos! Es importante continuar vigilando el contenido de la tecnología a la cual se expone su hijo/a. Esto incluye los video-juegos, los sitios web de transmisión en vivo (streaming) como Twitch y YouTube.  También vigile las aplicaciones de redes sociales como TikTok, Instagram y Snapchat para establecer límites apropiados según la edad de su hijos/as.

  • ¡Salgan al aire libre!  Sabemos que estar en la naturaleza es provechoso para nuestro estado de ánimo.  Propóngase salir de la casa por un tiempo todos los días. Esto puede incluir una caminata familiar por el vecindario, pasear a sus mascotas, rastrillar las hojas (u otro trabajo de primavera en el jardín), un almuerzo al estilo de picnic en el patio o simplemente sentarse en el césped mientras lee.

  • ¡Muévete, muévete! Es posible que lo haya oído muchas veces, pero es cierto: la actividad física hace maravillas para cambiar el estado de ánimo. Aún solo 5 minutos de actividad moderada pueden mejorar tu estado de ánimo. No tienes que hacer ejercicios difíciles como flexiones y abdominales: intenta bailar al ritmo de tus canciones favoritas o patear una pelota de fútbol fuera de la casa. Considera dedicar tiempo diariamente para ejercitarte con tu familia.  Podrían hacer al menos 30 minutos de actividad en la mañana y 30 minutos en la tarde o noche. ¡Hacerlo juntos ayudará a toda la familia! Puedes leer nuestro material educativo sobre “El Ejercicio y Las Actividades en la vida del que tiene DT1” (Exercise & Activities) para asegurarte de que el nivel de azúcar en la sangre de tu hijo/a se mantenga estable durante cualquier actividad física intensa.

  • Adopta el hábito de la gratitud. Proponte dedicar cada día un tiempo para que cada miembro de la familia comparta eventos, momentos y/o cosas  por las cuales debemos de dar gracias.  No tiene que ser algo extraordinario, solo necesita ser algo significativo para la persona. Por ejemplo, un padre que prepara la comida favorita de la familia o un hermano que comparte un juguete.

  • Limite las noticias sobre la situación del COVID-19. Es importante mantenerse informado, pero enfocarse demasiado en la crisis puede ponerlo de mal humor y los niños pueden percibir o darse cuenta del estrés.

Consejos para mantenerse sanos y seguros

La mejor defensa contra cualquier enfermedad contagiosa es lavarse las manos frecuentemente y buscar ayuda médica inmediatamente si se da cuenta que alguien tiene síntomas.

 

A continuación, presentamos nuestras recomendaciones para los pacientes y sus familiares:

  • Lávate las manos con jabón y agua.   Los niños pequeños pueden disfrutar de lavarse las manos cantando una de sus canciones favoritas para alcanzar el tiempo recomendado de 20 segundos. Si eres fanático de los deportes de la Universidad de Michigan, ¡Lávate las manos mientras piensas o cantas la canción de la Universidad de Michigan!

  • Evita tocarte los ojos, la nariz o la boca con las manos sucias (no lavadas).

  • Cúbrete la boca y la nariz con un pañuelo desechable o usa el pliegue del codo al toser o estornudar.

  • Evita contacto con personas enfermas.

  • Desinfecta con frecuencia las áreas de alto contacto en tu hogar, incluyendo los fregaderos, mostradores, manijas de enseres eléctricos, perillas de las puertas y las áreas de baño.

  • Quédate en casa si estás enfermo/a y comunícate con tu médico de cabecera de inmediato si tienes tos, fiebre o estas corto de aire.

Consulte los enlaces o ‘links’ a continuación para obtener la información más actualizada sobre cómo tomar precauciones, síntomas del COVID-19, y la situación actual:

La JDRF grabó esta conversación con la Dra. Mary Pat Gallagher, directora del Centro de Diabetes Pediátrica del Hospital de Niños Hassenfeld en NYU Langone sobre la diabetes tipo 1 y el coronavirus.

T1D Care Tips

School and after-school activities provide kids with diabetes additional structure and supports daily diabetes management behaviors. When students are out of school, it can be at higher risk of struggling to complete their diabetes care, even when they typically do really well! Being cooped up at home can also lead to less physical activity and exertion which may affect blood sugars.

 

Here are our tips on maintaining a healthy T1D routine at home:

  • A daily routine is key!  Help your child as much as possible to maintain a fairly consistent routine when it comes to to sleep and eating schedules. This helps anchor care to typical activities. Remember, you should be checking blood sugar when you wake up, before you go to bed, before every meal and snack, and any time you are feeling the symptoms of a high or low blood sugar.

  • Educate any additional caregivers. This situation has prompted many families to rely on new or less T1D-experienced caregivers. Be sure to share our education resources including the New Onset Guide or JDRF's resources to provide quick and accurate education.

  • If you’re not together during the day, send pictures of devices when possible. It’s better to lay eyes on the meter or pump than rely on verbal report - not because your child is dishonest, but because it helps keep them accountable in the moment.

  • Set up a family “diabetes care review” conversation each day. Use this time to review meters, pumps, or CGM together. Focus your attention on what went well during the day and problem-solving how to improve care for tomorrow. Avoid focusing on missed opportunities for care, as this is unlikely to help your child do better tomorrow.

Education Resources

With schools closed, many children and teenagers are lacking the structure of their ordinary schedule. Below are some tips and resources for children and teenagers to maintain their academic skills during this time away from school.

  • Stay connected with school. If your child's school is offering virtual classes, be sure to help them connect and complete assignments as required. Review assignments from the school, and help your child establish a reasonable pace for completing the work. You may need to assist them with turning on devices, reading instructions, and typing answers. Stay in touch with teachers and school staff if your child is having trouble with the assigned materials or if you have difficulty connecting to lessons.

  • Create consistency. Create a schedule and routine for learning at home, but try to remain flexible. Start with a consistent bedtime and wake up time during the week. Break up the day with time for learning, time for play, time for meals and snacks, and time for physical activity. Most importantly, allow yourself flexibility in the schedule - it's okay to adapt from day-to-day as things come up.

  • Practice makes perfect! One of the best things you can do for your children is practice what they have learned in school. Review vocabulary words from science and language arts, practice math problems and create your own word problems, and give presentations on history or books they have read. You can search for instructional games or grade-appropriate activities online to help you.

  • Make learning fun. Children love hands-on activities like puzzles, painting, drawing, and making things. YouTube and Facebook can be great places to check for tips on these kinds of activities. Playtime can also be used in place of structured learning when appropriate - encourage your children to build a fort from sheets or practice counting by stacking blocks. Practice handwriting and grammar by writing letters to family members or starting a journal. Listen to audiobooks or see if your local library is hosting virtual or live-streamed reading events. JDRF has assembled this fun list of "quarantine activities" that can spark creativity or interest in learning.

  • Give freedom to explore. If your child is happily engaging in art, reading, science, or history, let them explore! Self-directed learning is one of the most effective ways to absorb educational material. Don't feel the need to move children from topic to topic if they are enjoying a particular subject and are staying productive.

Promoting Academic Skills at Home

Telemedicina para Pacientes con Diabetes

Debido a la situación actual del COVID-19 (Coronavirus), Michigan Medicine está recomendando que los pacientes sólo acudan al hospital en situaciones de emergencia. Al mismo tiempo, las compañías de seguros aún requieren la asistencia que el/la paciente asista a una visita clínica de diabetes con el fin de aprobar los medicamentos y suministros respectivos. Con el fin de continuar el tratamiento de nuestros pacientes, la Clínica de Diabetes Pediátrica de U-M está haciendo los esfuerzos necesarios para transferir todos los pacientes elegibles a visitas por medio de vídeo (telemedicina). En este momento no se programarán exámenes de laboratorio, pero una vez que se regrese a nuestras operaciones regulares, nos encargaremos en programarlos.

 

Necesitamos de su ayuda para realizar la transición a telemedicina en este corto plazo.

 

Para realizar una transición exitosa a telemedicina, por favor siga los siguientes 3 pasos. Hemos creado una serie de guías útiles para asistirle en el registro en el “Portal” del paciente de U-M (MyUofMHealth), así como guiarlo(a) en como descargar la información de su diabetes en una plataforma de información. Con el fin de evitar un alto volumen de llamadas, por favor lea los materiales con cuidado antes de solicitar asistencia.

1. ¿Cómo registrarse en el “Portal” del paciente de U-M (MyUofMHealth.org)?

Si aún no se ha registrado en el “Portal” del paciente de U-M (MyUofMHealth), deberá de crear una cuenta para su hijo(a) usando las instrucciones que encontrará en el Registro “Portal” del paciente. El “Portal” le permitirá ver los resultados de los exámenes de laboratorio de su hijo(a), ver y pagar facturas, así como mandar mensajes a su equipo de atención de diabetes cuando necesita ayuda.

2. ¿Cómo conecto mis dispositivos de mi diabetes a una plataforma de datos?

Para poder participar en una visita virtual (Telemedicina por Vídeo), deberá descargar los datos de sus dispositivos de diabetes de los últimos 14 días a la plataforma de datos correspondiente.

 

Si necesita ayuda para determinar cuál plataforma de datos de diabetes tiene que usar, instrucciones sobre cómo registrarse o información sobre cómo compartir sus datos con la clínica de diabetes pediátrica de U-M, consulte nuestra Guía de descarga de datos del paciente.

3. ¿Cómo envío un mensaje a través del “Portal” del paciente?

Una vez que se haya registrado en el “Portal” del paciente y haya descargado los datos de los dispositivos para el manejo de su diabetes en la plataforma correspondiente, deberá de mandar un mensaje a través del “Portal” a su equipo de diabetes para informarles que están listos para realizar la visita de telemedicina por vídeo. Para instrucciones detalladas de como enviar este mensaje a través del “Portal” favor revise la página 8 de la Guía de descarga de datos del paciente.

  • How do I get my child ready to go back to school after being diagnosed?
    Going back to school after a new diabetes diagnosis can be stressful. It is important that you are prepared to make the transition as smooth as possible. Talk with your diabetes care team about developing a Diabetes Medical Management Plan (DMMP) for your child at school. Be sure you have diabetes supplies for school and tell the school what to do in case of emergencies, like extremely low blood sugars.
  • What is a school plan (DMMP)?
    A Diabetes Medical Management Plan (DMMP) explains everything school personnel need to know about your child's diabetes management, including whether your child needs help checking their blood sugar, how to treat low blood sugar (hypoglycemia), and how to manage meals and snacks. Drafting a DMMP takes place between you and your care team, and should be completed before the start of each school year.
  • What is a 504 plan? Do I need one?
    A 504 plan is a formal, legal action plan made with your child’s school that outlines the school's responsibilities in managing your child’s diabetes to make sure your child is safe and is treated fairly. The 504 plan can help reinforce the commitments made in the DMMP. For a sample 504 plan, click here.
  • What is an IEP? Do I need one?
    If a student with diabetes has special education needs that qualify under the Individuals with Disabilities in Education Act (IDEA), an Individualized Education Plan (IEP) may be needed instead of a 504 plan. An IEP is a document that outlines what the school is going to do to meet the child's individual education needs. To qualify for an IEP, a child must have an impairment that affects his or her academic performance.
  • My child's school won't let my child attend because they do not have a school nurse. What can I do?
    It is not legal for your child to be barred entry to any public or private school that receives federal funding because of a T1D diagnosis. Even if your school does not have a nurse, all schools that receive public funds are required to train a responsible adult to carry out the Diabetes Medical Management Plan (DMMP). They cannot exclude a child from school because of type 1 diabetes or force parents to come to school to handle the diabetes care activities. It is important to remember, the school staff are likely not medical professionals; be patient and remember that you are a team in taking care of your child's health and well-being. ​ If you continue to have trouble with establishing the school's role in your child's care, you may contact us about creating a 504 plan.
  • My child's school wants me to come in and perform blood glucose checks and insulin injections. What can I do?
    You are not required to leave work or disrupt your schedule to perform routine care for your child's diabetes while they are at school. Even if your school does not have a nurse, all schools that receive public funds are required to train a responsible adult to carry out the Diabetes Medical Management Plan (DMMP). They cannot exclude a child from school because of type 1 diabetes or force parents to come to school to handle the diabetes care activities. It is important to remember, the school staff are likely not medical professionals; be patient and remember that you are a team in taking care of your child's health and well-being. ​ If you continue to have trouble with establishing the school's role in your child's care, you may contact us about creating a 504 plan.
  • What supplies should I take to school?
    Your Diabetes School Kit should include: Extra glucose meter Blood glucose test strips Juice boxes, glucose tablets, and/or glucose gel Glucagon Granola bars or other small snack Ketone strips Bottled water (if your child won’t drink school water) ​Your child should always have access to something to treat a low blood sugar. Snacks or glucose tablets should be kept with the student, in case of a fire drill/lock-down/shelter in place, as well as in classroom, in the locker room, and on the school bus. For younger children, ask the teacher to keep juice boxes or glucose tabs in their desk. Be sure any substitute teachers, including substitute bus drivers and office staff, also know about this arrangement. Older children should carry supplies in their backpacks or in their pockets.
  • Where should I keep my glucagon at school?
    It is very important that your glucagon is kept somewhere accessible where others can find it in case of emergency. If you leave your glucagon in your school's office, you need to have a plan in place for someone to retrieve and administer the shot. It is advisable that you leave your glucagon on your person, possibly in a backpack or handbag.
  • What if my child gets low at school?
    Highs and lows will happen at school, at home, and in many areas of your child’s life. Good diabetes management means responding quickly and calmly to correct blood sugar levels until they are back in target range. If your child is low at school, they should have access to a quick carb snack or glucose tablets or gel. Make sure your child’s teacher understands the need to have these supplies on hand and what to look for when your child is acting low. If your child loses consciousness, your child’s teacher or a responsive faculty member should have access to the child’s glucagon kit and be aware of how to give the injection. It is recommended that you review these steps with anyone who will be helping your child with their diabetes as a part of their T1D training.
  • What should I do during a test?
    By establishing a 504 plan with your school, patients are allowed special accommodations during Michigan state tests such as M-STEP/PSAT/SAT/ACT. If you need a snack, you are allowed to have one present during the exam. You may have permission to use a cell phone to monitor CGM values, but you must receive approval for all test accommodations with the test proctor and the school staff ahead of time. For certain tests, a letter from your clinician must be provided to the College Board in order to receive these accommodations. The College Board approval process may take up to 8 weeks, so be sure to plan ahead. A good reminder is to discuss standardized testing dates during the fall at the same time you are reviewing your 504 with the school. Please contact the clinic if you have questions about these issues.
  • How do I tell my friends about my diabetes?
    Talking about T1D with friends, family, and strangers can be difficult. Even if you are successful in managing your diabetes, it can be stressful discussing this personal information with new people in your life. JDRF offers a free PDF on how to talk about T1D with friends, family, coworkers, and in a variety of situations here.
  • Who needs to know about my child’s T1D at school?
    You and the school staff are partners in your child’s education and well-being. Strong and clear communication is crucial to the success of your child’s health. Staff you should consider educating about T1D include: Principal Nurse Guidance counselor Teachers P.E. teacher Latchkey / after-school program supervisors Cafeteria staff Coaches or extracurricular supervisors Bus drivers JDRF offers a free PDF that may help you in facilitating a relationship with your school here.
  • Are there scholarships for my college student with T1D?
    There are several scholarships just for teens with type 1! Click below to learn more about the College Diabetes Network (CDN) and other scholarship opportunities. College Diabetes Network (CDN) Diabetes Scholars Foundation Novo Nordisk Donnelly Awards (for teen tennis players with type 1) Seefred Trust Scholarship (Ohio residents only) ​Please note: These opportunities are typically open January-April. Check the Off to College (Teens) page for other opportunities.
  • How should I prepare for college life with T1D?
    Moving away from home with T1D can be a scary thought, but it is very possible to have a happy and healthy experience at college with T1D. To prepare you for this new chapter in your life, please check out our Off to College (Teens) and Off to College (Parents) pages. Please also feel free to check out College Diabetes Network's "Off to College" booklets on their website and request a physical copy in clinic.
Mental Health Tips
Health & Safety Tips
Education Resourcs
Clinic Virtual Visits
T1D Care Tips
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