When your child has type 1 diabetes, you walk a thin line. You need to keep your child safe, but still give them the independence to manage their own condition as they grow. With each birthday, your child will spend more and more time away from you. And wherever they go, their diabetes goes with them. Teaching them how to manage it early in life will give you both the peace of mind that comes with knowing that they can handle it on their own.
Teach the Danger Signs
Perhaps the most important part of diabetes management is learning the signs of high and low blood sugar.
Ketoacidosis: This is a state of very high blood sugar where acids (ketones) build in the blood. There are many signs or ketoacidosis, but your child may:
- Be very thirsty and pee a lot
- Be tired and confused
- Feel sick to their stomach
Hypoglycemia: This is when blood sugar levels get very low. It triggers several symptoms too. Your child may be:
- Pale and shaky
- Sweaty and anxious
- Hungry and feel like they may throw up
Both ketoacidosis and hypoglycemia can get dangerous very fast. That’s why it’s so important that your child (and the adults around them) know the signs and what to do.
Set the Stage for Success
It’s important your child knows that their type 1 diabetes won’t limit them. But from the get-go, they need to be aware it’s a serious health condition and learn to manage it the right way.
Young kids: Use simple words and involve them in their own care to set up a lifetime of managing it themselves. Ask your preschool-age child which finger they want to use for blood sugar testing or where they want their insulin shot. Let them pick where they want their continuous pump attached.
Older kids: With your supervision, gradually hand over some responsibilities to your elementary or middle school-age child. Start with one task and gradually give them more to do. Consider asking the diabetes team which ones are appropriate for your child to take over and at what age. Keep in mind that once your child hits puberty, their needs for insulin will change.
Teens: Hopefully, they’re managing their diabetes largely on their own. But this age can be tricky because teens want to fit in and not feel “different.” Touch base and ask how it feels to be at school and around friends when they have diabetes. If they have a continuous glucose monitor or pump, how do they feel about wearing it?
Know that their insulin and eating routine may need to be adjusted if they sleep in late or have an unpredictable schedule. Talk with them about drugs and alcohol, since these substances can affect blood sugar levels.
Diabetes and Emotions
It’s normal for your child to be angry or sad about their diabetes sometimes. But if it goes on for a while, there may be a problem. Signs that sadness may be moving into depression include:
- Consistently high blood sugars
- Frequent moodiness or sadness
- Unusually bad grades in school
- Eating and sleeping more or less
If you see these signs, ask the nurse practitioner at your child or teen’s school or talk to a social worker or counselor for an appointment to screen your child for depression.
Type 1 diabetes management can create family conflict, especially as a child gets older and wants to test limits. It’s possible your well-meaning concerns may come off as nagging or scolding to them. If the situation gets to be too much, reach out to your diabetes educator, social worker, or a therapist. Family counseling can help.
Type 1 Diabetes Away From Home
Kids spend half their waking hours in school. So you need to make sure all adults there know how to help with your child’s care. Older kids may feel comfortable checking blood sugar, injecting insulin, or adjusting a pump. Young ones or those recently diagnosed will need help to stay on top of it all.
Things to do to keep your child safe at school include:
Make adiabetes medical management plan (DMMP): Meet with your child’s health care team before each school year to make a personalized care plan. This may cover:
- The blood sugar numbers to target
- Whether your child needs help to check their blood and how to help if they do
- Insulin and other medications – who’ll give them and where they’ll be kept
- Signs and symptoms of high and low blood sugar and how to treat them
- When to give glucose tablets or another fast-acting sugar, and how much
- A meal and snack schedule
- How to manage physical activity like gym class, recess, or sports
Consider a Section 504 plan: This is a legal plan you work out with the school. It covers your child under the section of federal law that protects people with medical and other disabilities from discrimination. It applies to programs and schools that get federal dollars. Your DMMP is a key part of a 504 plan.
This plan:
- Protects your child at school so they get the care they need
- Explains in detail the responsibilities of different school staff members, from the bus driver to the principal
- Ensures that your child’s educational needs are met
- Makes sure your child isn’t restricted from school activities or clubs
You may want to add details like requesting a desk near a door, to access the bathroom quickly or get to the nurse’s office discreetly. Ask that your child be allowed to stop taking a test if they don’t feel well. Speak up about any other needs your child has, and get the school’s response in writing.
Teach your child to respectfully but forcefully ask for what they need, too.
Diabetes and Social Activities
When the school day and homework are done, it’s time for fun. Your child may want to have a play date or have a sleepover on the weekends. It’s easiest to invite other kids to your house so you can help manage your child’s diabetes. But that’s not always possible. Your child will want to go to friends’ houses, parties, the movies, and more. It’s important to let them go, not only because it’s fun, but it also teaches independence.
- Let the other parent know your child has type 1 diabetes, and let them know the basics of care and what to watch out for.
- Make sure they or your child can reach you quickly by phone or text.
- Have your older child check their blood sugar late into a party or right when they get home.
During the summer, you may want to look into diabetes camps. These are specifically for kids with diabetes and are staffed with medical professionals to keep them safe. It can be a great experience for your child, teaching self-confidence, independence, and more. Plus, they’ll be around other kids with type 1 diabetes, so care isn’t something that makes them different. It also gives you a break from the day-to-day responsibility of your child’s diabetes care. These camps are widely available, and most offer financial assistance, if you qualify.
Type 1 Diabetes and Sports
Type 1 diabetes shouldn’t keep your child off the playing field. Sports, and exercise in general, is an important part of diabetes management. But type 1 diabetes does add an extra layer of responsibility for you and your child, along with their coaches and trainers.
Take these steps to keep your child safe:
- Meet with their coaches and trainers to explain what type 1 diabetes is and what’s involved in its day-to-day care.
- Let them know your child may need extra water and bathroom breaks.
- Explain that physical activity means your child’s blood sugar may drop or get too high.
- Alert them to the signs of an emergency and when to call 911.
Your child needs to know how to play it safe. Go over with them how to:
- Pack a diabetes to-go kit with their sports gear with all the diabetes essentials plus healthy snacks and some candy for dips in blood sugar.
- Speak up to a coach or trainer if they don’t feel well.
- Stay hydrated.
Diabetes and College
Making the transition to college is a huge step in a young person’s life. If your child is planning to go, they’re entitled to accommodations – something they need to advocate for themselves. They’ll need to contact their college or university’s office of disability services. Most likely, they’ll also need to ask their doctor to provide a letter that states the diagnosis.
Your student may need to push for academic accommodations that include:
- Priority registration so classes fit their medical needs
- Official notification of teaching staff about their diagnosis
- The ability to take breaks during class time or exams for self-care
- Rescheduling of exams or excused class attendance if they become ill
If your student is living on campus, they should:
- Tell their roommate that they have type 1 diabetes and how they manage it.
- Make sure there’s a set space in the shared dorm or apartment fridge for their insulin and snacks.
- Tell the resident assistant (RA) about their diabetes, if there is one.
- Let their RA and roommate know the signs to look for that they may be in serious trouble.
- Inform the student health center and figure out how they’ll get their diabetes medication, insulin, and other supplies.
- Always wear a medical ID bracelet.
Parties and alcohol are often a part of college or even high school life. Before your child leaves for school or just a night out, have a heart-to-heart with them about drinking and the dangers that can arise when someone with diabetes indulges. This is typically low blood sugar, but it can be unexpected highs, too. If not taken care of, these conditions can lead to seizures and even death. And when you’re not sober or “sleeping it off,” it makes it harder to do this safely.
Show Sources
Photo Credit: E+/Getty Images
SOURCES:
American Diabetes Association: “Section 504 Plan.”
Beyond Type 1: “College/University with Type 1,” “The Alcohol and Diabetes Guide.”
CDC: “Managing Diabetes at School”
Children’s Hospital of Philadelphia: “Coping With Diabetes.”
Children with Diabetes: “Diabetes Camps.”
JDRF: “When Type 1 Meets The Teenage Years,” “Minimizing T1D-Related Family Conflict and Improving Communication,” “Helping a Child With T1D Navigate Social Situations.”
Joslin Diabetes Center: “Managing Diabetes at School.”
Journal of Pediatric Psychology: “Family Therapy for Adolescents with Poorly Controlled Diabetes: Initial Test of Clinical Significance.”
Mayo Clinic: “Diabetic Ketoacidosis,” “Hypoglycemia.”
Nemours KidsHealth: “Helping Your Child Adjust to Diabetes,” “Helping Your Young Athlete With Type 1 Diabetes.”
