Interkulturelle Aspekte in der Diabetestherapie von Kindern und Jugendlichen.

In the management of diabetes, a significant degree of self-management is required not only from those affected, but also from those close to them. Furthermore, linguistic and cognitive abilities of patients and their families play an important role in patient outcome. Cultural aspects can affect acceptance of the disease, the necessity of insulin therapy, and treatment goals. In many cultures, visible signs of the disease are often associated with social consequences for those affected and possibly their families due to differing interpretations of the disease. Thus, empathic questioning, understanding, and clear explanations from the diabetes care team are important for successful implementation of insulin therapy. It is important to avoid generalized statements about cultural differences and their impact on acceptance and implementation of diabetes therapy because differences regarding concepts of disease between people with supposedly the same culture or heritage can be significant. When selecting insulin therapy for type 1 diabetes, priority should be given to regimens that can be used correctly. It is also essential to determine how the treatment costs will be covered. Families should be taught the necessary skills for insulin therapy through training and consultations. In cases with language barriers, use of a professional translator is recommended. Sensitive knowledge transfer focused on the essentials—taking into consideration individual needs, cultural contexts, and possible unique circumstances—is key to successful diabetes training. Regarding acceptance and implementation of training, it appears that the country of origin may play a more important role than the migration background. The growing prevalence of obesity among children and adolescents in both industrialized and emerging countries and its increased risk of diabetes that is associated with this places a strain on development opportunities of those affected and on healthcare systems. If diagnosed early, endogenous insulin production is still preserved, and treatment should consist of lifestyle changes aimed at weight reduction and, if necessary, the use of antidiabetic drugs.