It’s Day 2 of the Children with Diabetes Friends for Life conference in Orlando. The hotel is cold, but the people are warm. Today I attended a wonderful session with clinical psychologist Barbara Anderson, who has 30 years of experience in diabetes research and clinical work. Her talk, “Family Teamwork in Diabetes Management”, was full of useful pointers for parents of children with diabetes and I’m going to post a summary below. (Note: I missed the first few minutes of the talk so I don’t have the information about the youngest children with diabetes.) As I entered the room, Anderson was saying, “Nothing you did or your child did caused diabetes.”
Challenges for parent when child has diabetes (ages 7-10):
-Child with diabetes needs to begin to participate with peers
-Teamwork expands to peer group’s families, coaches, etc.
-Parents must sustain involvement in diabetes tasks while fostering child autonomy.
What can you do to foster autonomy in 7-10 year olds?
1.Ask what they’d prefer to use to treat low blood sugar.
2.Ask if they’d like to participate in their injections.
3. Kids this age don’t have a lot of self-regulation so adult supervision is necessary. But you could ask them to pick which finger to check their blood sugar on, or if they want apple juice or orange juice.
-You have to understand your child – some 10-year-olds are ready to be involved and some aren’t.
Tasks of young transitioning teens (11-14 years) and parents:
-Pubertal changes impact self-image.
-Peers increase in value. (The voice the parent is less valuable).
-Privacy is important. That doesn’t mean that they should be allowed to go close the door and check BG/insulin. Anderson says use your “mother muzzle” Don’t nag. Just keep your mouth shut.
-Power shifts in parent-child relationship.
Parent learns to acknowledge this is a period of insecurity and intensity, to negotiate, to have consistent expectations, to set limits, to maintain teamwork involvement and support.
Developmental tasks Mid-Late Adolescence
-Consolidating Identity Development (self-image, body image, sexuality, future education/training, employment)
-Beginning to plan for transition after high school
-Peer group has priority
-Cognitive growth (abstract thought, problem-solving)
Kids at this age can do a lot, but not long-term thinking.
Communication tips for enhancing family teamwork and preventing conflict:
Use the right words: BG checking or monitoring not BG testing
Use high and low BG, in-range or out of range BG, not good BG and bad BG
Use diabetes management, not diabetes ‘control’
The word control implies you can control the biological outcome and you can’t. You can only control the behavior.
Keep in mind all of the things that can affect BG. There are going to be 1/3 of numbers that neither you nor your doctor will be able to understand. Could be bad insulin, fighting infection, hormones, many young women spill ketones every month before period.
How a parent talks to child (with words or facial expressions about BG…) makes an impact:
Don’t say: “That blood sugar is so bad. What did you eat?
Avoid shame and blame around BG and remember:
1) Occasional high blood sugars don’t lead to complications. It is normal for growing children to have out-of-range blood sugars. An occasional blood sugar of 300 or even 400 or more will not cause complications.
2) There is no such thing as a “bad” blood sugar. Any results from blood sugar monitoring is good because it gives helpful and important information that lets you make the best choices in insulin, activity, and food.
Miscommunicating leads to diabetes burnout and emotional exhaustion. Emotional exhaustion is very common in teenagers.
Diabetes Burnout is preventable:
-Watch for early signs of burnout , and find ways to hep relive the sress
-Talk about your negative feelings about diabetes.
-Set realistic goals with your health care team.
-Think of ways that your family and friends can help ease the burden of diabetes.
-Make changes in your diabetes care one small steop at a time.
-Diabetes is not about “passing or “failing.”
No one can successfully manage diabetes all alone.