Remember that how you deal with and accept diabetes will often determine the way your child deals with and accepts diabetes. Although you are naturally anxious, it's up to you to help your child accept his or her diabetes with a minimum of stress. The Juvenile Diabetes Foundation, www.jdf.org, and the American Diabetes Association, www.diabetes.org, can be of great help.
In reading volumes on the subject and talking with my own endocrinologist about children with diabetes, here are a few pointers that I picked up:
- Learn to protect without dominating. Learn how to encourage self-care appropriate to their age level. Work with your child for the best control, but remember that "ideal" control isn't always possible.
- Try to avoid unnecessary anxiety about "cheating." You don't want to cause guilt feelings, or make your child think he or she is "bad." Children who think they are bad may act accordingly.
- Understand that no child can or can be expected to assume complete responsibility for diabetes control at too early an age. But, ultimately, the responsibility for eating properly, injecting insulin, testing blood sugar levels, and exercising will be the child's.
- A child with diabetes is a child first, and a person with diabetes second. As they grow and learn self-care, they will gain independence, self control, and self esteem.
Just as in other areas of parenting, an overanxious parent tends to create an overanxious child, who is over dependent. If you do everything for your child, you're not allowing him or her to exercise self-control and to gain self-confidence. If you feel that dietary restrictions and daily injections are too much for your child to handle, by overindulging them by doing everything for them, your child may grow up under the impression that you think them to be incompetent and unable to cope with their problems.
If you a perfectionist who achieves good diabetes management with your child through discipline, be aware that you may be setting your child up to feeling guilty if they have occasional poor blood sugar test results. They may not even report such poor test results for fear of discipline. During adolescence, children of perfectionist parents may rebel-against their parents and their diabetes care programs.
An indifferent parent may force his or her child to seek attention through rebellion, by "cheating" on the diet, or by skipping insulin injections. Children of indifferent parents may also become depressed because of the lack of discipline and supervision in their lives.
Here's an idea of what to expect from your diabetic child at different age levels.
Years 0 through 7
During early childhood, you the parents have full responsibility for all aspects of your child's diabetes care. It's important, however, to involve the child at an early age. Offer the child some 'say' in picking a spot to inject or choosing which finger to use for testing. Never describe blood test results as good or bad, instead use the terms high, low, or normal.
Years 7 through 12
Although you still need to take the major responsibility, at this age level the child can take over blood glucose testing and insulin injections some of the time. By age 12, most children can handle their injections, but parents must be sure to remind them if they forget. Teach your child that when away at school or off playing with friends for most of the day, he or she must assume partial responsibility for what they eat. By participating in self-care at an early age, your child will become independent and self-reliant. Be flexible and talk with your child about how to handle eating at parties and special occasions. You don't want them to feel different. A serving of birthday cake and ice cream may elevate blood sugar, but the emotional value of participating with other children is also important. Ask your doctor how to cover extra food with a few units of regular insulin, if your doctor approves.
Years 12 through 17
All adolescents will resent dependence on their parents. Once you and your child are well versed about diabetes and its management, he or she should be permitted to participate in treatment decisions. Adolescents may rebel and act as if they don't have diabetes, ignoring their treatments (especially diet), and misrepresenting blood sugar tests results. Depression at this age is not uncommon. Since they will be quite aware of diabetic complications, they may refuse to take care of themselves, assuming they will die young anyway. It's your responsibility to make sure your child understands the importance of good control. Help them understand the significant improvements that have been made in diabetes treatment in recent years and make sure your child is aware that many people with type 1 diabetes do lead full, rich lives. Searching the Net, they can develop the names of many young adults with type 1 diabetes to "adopt" as a role model. Don't hesitate to contact a professional counselor or seek a self-help support group for children of their age level. Teenagers need someone to talk with besides their parents. Let your teenager meet with his or her doctor or diabetes educator alone.
Lastly, make sure your child's teachers, school nurses, and other school personnel understand your child's diabetic condition. Read our previous article about your child's rights at school. Your child's teacher will also benefit from specific information about your child's particular diabetes control requirements. It's also a good idea to visit or call the school about once a month to see how things are going. Since your child spends a lot of time at school, the teacher may see or hear something before you do regarding your child's behavior and diabetes control.
REMEMBER: The care of diabetes is a team effort involving you, your physician, the diabetes education staff, and, at the appropriate age, your child. Always remain in touch with your child's physician and diabetes care team, bringing any questions you may have about your child's diabetes management to their attention.
FTG
