As an adult with Type 1 Diabetes (T1D) and mother of three children—one of whom also has T1D—I have learned that this chronic illness can easily present mental and emotional challenges. My experience, however, has also taught me that parents and patients can make healthy choices to lessen these burdens. It is from my parenting and patient perspective that I share the following with you.
AN OVERWHELMING ILLNESS
Kids (and people in general) with T1D have loads to keep track of at all times—whether it means monitoring their blood glucose levels and counting the carbs that they consume, or maintaining a healthy supply of prescriptions and medical equipment at all times. When prescriptions run low or worse…run out, we parents go into scramble mode.
T1D isn’t exactly convenient either. Those with T1D don’t always eat whenever they want because eating nearly always requires some degree of planning, regardless of how hungry (or “hangry”) a child may be. When families sit down to eat a meal, those with T1D are encouraged to first check their blood glucose, calculate the carbs they plan to eat and take appropriate levels of insulin. Delaying gratification for kids (or anyone) is tough. If the child’s blood glucose level is high, he may do well to delay eating. If it’s low, it may make sense to begin his meal with a juice or fast-acting carb, regardless of what he wants.
FINANCIAL ISSUES CAN ADD TO THE STRESS
The financial aspect of having T1D is enough to send many parents into an all-out panic attack. According to an article published by CNBC, diabetes is the most expensive disease in the United States. Yet, the disease doesn’t discriminate. Whether you’re wealthy, poor or somewhere in between, ensuring healthy control of diabetes costs a lot of money.
Altogether, these things can add great stress to children. Luckily, the Diabetes Center at Cincinnati Children’s does an excellent job helping children and families navigate diabetes management, and more and more support groups and online resources have become available.
KEEPING TABS ON YOUR CHILD’S MENTAL HEALTH
Nonetheless, the mental and emotional effects of the disease can take a toll on children, which is why it’s important to pay attention to your child’s mental health. If she is not well from an emotional point of view, she will likely have more difficulty managing her diabetes, if not now, in the future.
From a personal parenting and patient perspective, I am happy to share some things that have worked well for our family. Parents and caregivers can follow these seven tips to support their child’s mental health / emotional well-being:
Acknowledge your child’s efforts.
Understand that managing Type 1 Diabetes is difficult, even for adults like myself who have had the disease for more than 25 years. Many factors affect blood glucose levels. Not only what one eats and when, and how much insulin one takes and when, but the level and type of activity, stress, health/sickness, and time of day, all could have an effect. That said, acknowledge your child for the efforts he attempts to make in maintaining in-target blood glucose levels. Let him know that you notice and recognize his hard work. From time to time, you may say, “Hey, I noticed you’ve been working really hard at managing your diabetes. That’s a big job that requires hard work and you’re doing it!”
Proceed gently with reminders.
Gentle reminders can help a child stay focused on maintaining blood glucose levels. But use caution because too many reminders or “helicopter parenting” can backfire and cause the child to rebel against you and diabetes care. It can be a delicate balancing act for parents. Choose what to say, when and how, very carefully. By being overbearing, you could send the message to your child that you don’t believe she is capable of managing her diabetes. This can add stress to your child. Know how much meddling is too much meddling. At some point in her lifetime, your child will likely have to manage on her own. Give her the space to make some small mistakes as long as she is healthy so that when she is older, she knows what to do and what not to do in order to stay healthy.
Ask your child if he wants or needs a break.
Older kids and teens may not need as much direct help as often. However, they may still need a break from managing their disease from time to time, or for you to help support them more periodically. They may wish to take a day or even just a few hours off without having to think about their blood glucose levels or carb intakes. You may be able to take this great responsibility off their hands for a few hours by checking their blood glucose or administering their insulin for them. Make sure that you are asking them when and how you can be helpful. Heck, they may even thank you for it afterwards!
Be quiet and listen to your child.
When your child gets frustrated with diabetes (everyone does) listen to him. Try your best to put yourself in his shoes. Allow your child to vent and cry. Do not argue or dismiss what he says or present a quick “Band Aid” fix. Be quiet. Listen with your ears, eyes, mind and heart. Sometimes, he may just need to know that you truly care and appreciate his struggle.
Advocate for your child.
If your child is in school, you may want to complete a Section 504 Health Plan to ensure her grades or rights will not suffer from taking time out to care for her diabetes. For example, the Plan can protect her if she needs to leave class early, miss a day of school, eat a snack, drink a juice in class or be granted extra time to complete a test because of her diabetes care needs. Your child is protected under law with a Section 504 Health Plan in place that spells out her rights and protects her from discrimination. As a parent, you can advocate for your child by reminding her and her teachers about the Plan. This could help decrease your child’s stress when trying to navigate this at school.
Pay attention to your child’s mental health / emotional well-being.
According to the American Diabetes Association, research reveals that children and young adults with T1D display increased risk of depression and anxiety. Fluctuating blood glucose levels can contribute to anxiety in a number of ways. Some children and even adults feel anxious about low blood glucose levels. Additionally, uncontrolled blood glucose levels can contribute to depression, fatigue or feelings of hopelessness. Some children benefit from talking to a therapist on a regular basis to help them manage their fears and emotions. Parents should pay attention to their child’s coping and adjustment and seek assistance from a professional mental health practitioner (counselor, social worker or psychologist) if necessary.
Take care of yourself.
Model healthy habits so that your child can follow your example. If you do not take care of yourself, you cannot effectively take care of your child or expect her to be any different. Our children learn from us. They model us. It is up to us to ensure that we set good examples for our children by trying our best to eat a healthy, balanced diet; get enough sleep each night; exercise regularly; drink plenty of water; reach out to family and friends for support when necessary; and manage our own stress levels so that it doesn’t spill over into how we interact with our children. Our chances of taking good care of our children then increases.
I have found these tips to be helpful as a parent of a child with T1D. You just may find that what has worked for me as a parent will also work for you.