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My 13-year old, the youngest of our two sons, was diagnosed when he was 12. He is doing fine, but I'm not sure I am.

My son is at an age where he's clearly trying to cut the apron strings (not rebellious, just not willing to be cuddled anymore), and I am doing my best to get used to the fact that my "baby" must growing up. We are a two, natural-parent family, and both my husband and I oversee my son's diabetes management. We have a good diabetes team of health care providers, and we have excellent insurance coverage.

Lately I find myself sad over the fact that my son has diabetes. He manages so well and carries on so very normally that I find myself often shocked all over again that he has this disease. Recently we cross-country skied quite a distance, something we enjoy. I looked at my son's face and realized he was having a "low." I had completely forgotted to bring a snack or glucose tabs (but so did he). We FORGOT about his diabetes! I nearly sat down and cried, but instead I talked him through it until someone got us some candy. I fretted that for days.

My son gets his bedtime shot of N at 11:00 p.m., long after he's asleep. Either my husband or I wake my son for his shot, and we usually set our alarm unless one of us is still up. The other night my husband was away, and I went to bed--completely forgetting about giving my son his shot! My husband woke me up at 1:00 a.m. to check to be sure I had done the shot--and it was a good thing! How could I forget? What if we had missed it?!

These two incidents have frightened me. (I haven't let my son know this.)

Is this normal? Am I subconciously trying to ignore this or waiting for it to go away? Why do I forget?!

I have talked to my son to let him know he must check on us, just as we check on him. He should ask each night who'll be doing his shot, and he should tell us his glucose reading and what his dose should be. This is one solution: have him be more responsible for what we've always done for him.

He's got chronic ear infections and has had multiple surgeries to correct his problems, so it's frustrating for me to try and understand what's going on with his blood sugars: growth spurts? infection? mismanagement? I think my whole problem is that I blow this out of proportion: I'm afraid he's gonna die. My protective instincts are rejected by this very self-sufficient child of mine, so I withdraw to give him space. Maybe it's his age and place in the family that I am having trouble with. Or maybe I am not dealing well with a child with health problems.

My RN CDE would laugh at me and tell me I'm normal and we have to get through it. In the meantime his blood sugars are in the 200s and we need to get control!

I would like to hear from other parents. Maybe we're still new enough at this that there's hope before he grows up?

Adolescence can be a difficult time for parents and their children without the teenager having diabetes. This is the time when parents must "cut the apron strings" and let their children gradually learn to take responsibility for themselves. Diabetes makes this process more complicated.

I think that the most important thing is for the parents and teenager to communicate and establish their own "family guidelines" for diabetes management. It is important to allow and encourage the teenager to take on responsibility when he or she is ready to. It is not uncommon for teenagers to say they want to be in charge, but really want the parents to care for them. Or they may want to be in charge one day and taken care of the next. In general, teenagers like to be carefree. Teens with diabetes obviously can't be completely care free or their diabetes may go seriously out of control.

I find it is important to be logical about issues of control and responsibility. If the teeneager wants to go places himself, he has to convince the parents that he will not forget to take his insulin or forget to carry emergency snacks. A good way to establish that a child is ready to be responsible by himself is to first allow him to be responsible when a parent is present or checking up on him. He also has to be reassured, that if he is not ready to be responsible by himself yet, it is OK, his parents will make sure he takes his insulin and always eats on time (even if he complains!), but he may not be able to paricipate in activities that require him to be responsible for these aspects of control. (This should not be presented as a punishment, but as responsible, loving parents making sure the child stays healthy.)

Although it may not be possible to get perfect control, especially during adolescence when both food and insulin requirements may be changing rapidly, it is especially important to impress on the teenager the importance of not missing insulin and not being caught unprepared without food, especially if engaging in an activity where a low blood sugar could be dangerous such as bicycle riding, swimming, skiing or driving a car.

I usually suggest that the parents help by keeping a pack permanently attatched to the child's bicycle stocked with cake decorating gel. Cake decorating gel can also be stored in the glove compartment of the car, the pocket of a ski parka, or a child's back pack. This way, if the child or parent (or whoever is "responsible") forgets to bring extra food, there is always an emergency back-up supply available.

As a practical matter, I would suggest that you try to give your son his 11 PM shot before you go to sleep. It is very easy to sleep through an alarm clock, and missing a shot can lead to ketoacidosis. You may want to suggest that your child also set an alarm and remind you if you don't come. You really can't ask him to be responsible, however, for a shot to be given after he is asleep. On the other hand, you may want to set up a time before he goes to bed to discuss his diabetes control and readings that day, and decide together on the 11 PM dose while you are both alert and awake.

I think that it is common and normal to be sad that your child has diabetes. Your child also is probably sad at times. It is OK to let your child know that you feel sad that he has diabetes, but that you want to help him keep his diabetes under control so he can be healthy and lead an active life. If your sadness is so persistant and severe that it interferes with your daily activities, or prevents you from enjoying your family, you may want to speak with your Physician or Nurse Educator about consulting with a therapist.


Original posting 15 Apr 96


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Last Updated: Tuesday April 06, 2010 15:08:52
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