When you think of your child with type 1 diabetes transitioning to self-care, to being responsible for him- or herself, you may be picturing the first week of college or the early days of boot camp. But long before those major transitions, there are a number of smaller, yet also important, steps that you and your child will take along the way to adult independence.
My child was diagnosed with type 1 diabetes young, so of course her father and I performed all of her tasks for her. But I remember when she was in kindergarten I asked her to wash her hands for dinner and, before I knew it, she had checked her own blood sugar. From then on we asked her to do most of her own blood sugar checks. Eventually we walked her through using her pump, although we would double check to make sure that she had done all the steps correctly.
Helping children learn to check their own blood sugar and adjust their own medications is, in my opinion as a caregiving parent, a key component of allowing them a little more freedom in the later grade school and middle school years. If your child can perform these tasks, or at least walk another caregiver through them, they may be more easily able to take part in independent afterschool activities and play dates. Training the adults who will be present is great, but sometimes, such as at birthday parties, the adult may be too busy to keep an eagle eye on your child.
It is important that tasks are age-appropriate; I found it was helpful to offer independence one step at a time. I can’t expect any child to make every decision perfectly, and the stakes are higher when the decisions involve blood sugar management. For example, your child might be able to check his or her own blood sugar, but may not be able to decide on their own how to recognize a low or remember to check again in fifteen minutes to make sure they have come back in range. I know my daughter could read a nutrition label at an early age, but she couldn’t always figure out the serving size if it was tricky. Until children have a good understanding of carb counting I don’t believe they can be expected to figure out their boluses. But working with them and double checking their work helps to set them up to make their own decisions as they mature.
Though the appropriate age for a child’s first cell phone is up for debate, we are looking into getting a basic cell phone for our daughter soon. Older children who have cell phones can quickly call or text their parents while at afterschool activities, play dates, and sleep overs to check in, confirm the decisions they are making, and give parents the reassurance that they are doing okay. This may also be helpful for children who ride the bus or walk home from school.
Additionally, it’s important to watch and listen so that you know when you need to take some of the tasks back into your own hands. In my experience, children can be overwhelmed by diabetes. We don’t want them to get burnt out; after all, they’ll have a lifetime of managing diabetes on their own.
Leighann Calentine is the author of the book Kids First, Diabetes Second and the website D-Mom Blog. She is married with two children – including a daughter with type 1 diabetes – has a graduate degree, and works for a major university doing research. Calentine is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor, and not of Sanofi US, its employees, agencies, or affiliates.
*“Certified Diabetes Educator” and “CDE” are certification marks owned and registered by the National Certification Board for Diabetes Educators (NCBDE). NCBDE is not affiliated in any way with Sanofi US. NCBDE does not sponsor or endorse any diabetes-related products or services.
© 2012 The DX: The Diabetes Experience