I remember the summers of my teen years as an idyllic time: sleeping late, impromptu trips to the lake with friends, mindless summer movies, “going out to get ice cream” and returning hours later, and just hanging out. Things haven’t changed too much in thirty plus years, and my fifteen year old daughter’s summer looms ahead of her, filled with possibility.
But Kate has something I never had to deal with—Type 1 diabetes. Diagnosed over four years ago, this isn’t her first summer managing Type 1, but it is her first summer as a high school student. Some of her friends already have their drivers’ licenses, and she has her learner’s permit. There is now a level of freedom and independence she has not encountered before. And that is how it should be.
We have prepared for summer vacation, so we can do our best to help Kate safe and healthy. We know she likes to sleep late in the summer, so we tweaked nighttime basals to accommodate the new sleeping patterns. That’s the easiest part! There’s so much more that goes into her having that “idyllic time” I had as a teen. But with some work and support, it can be done. Below are some things I keep in mind as I help Kate embrace the easy days of summer.
Activity changes mean dosing changes: Some kids are more active during the school year and others are more active during vacation. Basal rates that worked great in May could need tweaking in June. Heat and dehydration can also affect blood sugar. This is one of those “Your Diabetes May Vary” areas. I know I’ll need to watch my daughter little closer those first days of summer vacation so I can watch less once we’ve figured out the changes. (Don’t forget to always consult your doctor about any changes and follow his/her advice.)
Communication is key: How do I let Kate be a normal teen? I need to remember that communication isn’t just about me telling her what to do, but actually listening to what she has to say. We talk about situations that are going to occur and make plans for how to handle those events. While Kate may act like the last thing she wants to do is talk to me about all this, she knows talking it out ahead of time helps her win the freedom to not talk to me while she is out and around (or not talk to me as much).
Wet and wild on insulin: Beach/pool/waterparks: just thinking about my teen heading off to these without me puts fear in my heart. But with a plan in place, Kate can participate along with her friends. First, we agree on a communication strategy. I don’t expect Kate to text me each time she has a snack at a pool party, but I do expect a midday text if she is going to be gone all day. Kate pumps and wears a CGM. This summer, we will be at the beach more than we have been in the past, so we made the decision to take a CGM break. The thought of searching the Atlantic for a CGM transmitter doesn’t sound too appealing! Kate feels her highs and lows and treats them accordingly. Having the choice to use it or not, gives her a sense of control. She disconnects her pump if she goes in the water and puts it in an insulated lunch bag to stay safe. We have discussed the “untethered” approach to pumping; you use pump for bolusing and then use Lantus or Levemir for part, or all, of the basal insulin. This works very well for a number of pumpers. If you are interested, discuss this with your endo.
Parks and recreation: Amusement parks/concerts/festivals—we operate under the assumption that we cannot bring food or drinks into these venues and plan accordingly. It is easy to slip glucose tabs, fruit snacks, or skittles into pockets (cargo shorts are awesome) or a purse. Kate carries meter and test strips in her purse and of course, money to buy food and drinks.
Changes in Latitudes, Changes in Attitudes: In the spirit of summer and channeling my inner Jimmy Buffett, an attitude change is needed! I know I need to back off a bit but still stay connected. For us, the easiest way is to check Kate’s meter/pump once a day. If numbers look wacky, I will ask her to check again for me and then have her treat accordingly. But only after I ask her if she had fun!