Summary: This post is the first of two that will discuss giving your teen with type one diabetes more independence. Even though Q isn’t quite a teenager yet, we have transitioned a lot of her daily care to her.
Moving Toward Independence
At a diabetes camp geared toward parents of adolescents, an experienced counselor stood in front of a group of anxious parents and said something they didn’t expect to hear. Instead of telling parents to let go, he told them not to push for complete independence. Although teens want more freedom, most experts agree they still need parental involvement in their diabetes care. He also warned that if you remove yourself totally from their diabetes management, it will be much harder for you to step back in if there is a problem. Instead, he suggested that parents always keep a light hand on the situation. Now, that doesn’t mean you should be the dreaded “helicopter parent” who hovers constantly, nagging your kids about checking, monitoring every bite of food they take, and micromanaging their numbers. Parents do need to learn to let go, but it’s a delicate balance between giving them independence and keeping a pulse on things.
Parents who have lived through the teen years, as well as most medical care teams, say the same thing: start giving your d-kids age-appropriate responsibilities from the very beginning, building slowly toward independence. How much responsibility you give, and at what age, will depend on the personality and maturity of your child. I know some kids who started doing their own blood sugar checks as early as five or six years old, while others don’t feel comfortable about pricking their fingers until much later. However, by middle school, most kids are doing all their own checking, doing injections (or pump site changes), and are no longer relying on the school nurse.
As part of that transition, there should be some discussion about what your expectations are, and what the repercussions will be for not meeting those expectations. Some parents have found that having a written plan, including a schedule for checking, works well, while others use a less structured approach. Some families check meters daily, while others download information once a week and look at trends to see if their teen is on the right track. Again, the method will depend on your child’s personality and your own family dynamics. The important thing is to keep communications open and honest.
Your teen wants independence, but with independence comes responsibilities. So, for instance, your son or daughter may not want to check in with you as often as you’d like, but you still need to make sure your child is safe. Creating a compromise—“if you want to go to the dance, than you have to check in before and after”—can be an effective strategy. Also, working toward a goal may be a good motivator. When her type 1 son wanted to attend a week-long camp in sixth grade, d-mom Melinda Vahradian developed a plan over the months preceding the trip. If her son could demonstrate his ability to handle his care on his own, including pump site changes, then he could go. When the time came to evaluate his progress, she was amazed at how well he did. It also provided a good incentive to improve his math skills!
Like it or not, many kids with type 1 diabetes mature faster than their peers. We try to let them be kids first, but, out of necessity, they are faced with more responsibilities and are forced to grow up faster than other kids their age. This can be an advantage as they move into the teen years. The routines and good habits you’ve worked hard to establish over the years have undoubtedly become ingrained in your child and will serve him or her well as they move toward independence.
Remember, all teens separate from their parents—it’s a natural and healthy part of growing up. And, a certain amount of teenage rebellion is to be expected. However, as Bennet Dunlap, father of two type 1 teenagers and author of Your Diabetes May Vary (www.YDMV.net) cautioned, “While some rebellion against parents is natural, rebellion against diabetes is dangerous! When diabetes care is too parentally driven, it can become a constant point of contention; it can backfire and cause kids to rebel against diabetes as a surrogate for parents.” It’s far better to take a team approach, in which you’re working together to ensure children’s long-term health by helping them take responsibility for diabetes before the natural separation. That lets them rebel against you, not their diabetes. You are there to offer reminders, support, and guidance, but ultimately, they are responsible for managing their diabetes.
There is no magic formula for raising a teen with diabetes. What works for one kid may not work for another. Some parents have offered incentives for kids to comply with their care, and some have tried taking privileges away—neither has been 100 percent effective. In the end, teens must accept their diabetes and choose to comply on their own—with your support.
If you’d like to learn more about the book, you can read more on the Kids First, Diabetes Second book page. It’s available widely in print and as an eBook from book sellers such as Barnes & Noble, Amazon.com, and IndieBound. And if you do read it and find it to be a valuable resource, I would greatly appreciate if you could write a review on any of the online retail sites. Thanks!
Please remember that I never give medical advice. Ask your endocrinologist or pediatrician for advice about your own child. Make your own informed decisions for your own child. Links to book sellers are affiliate links.