After the initial period of adjustment, it is essential to help your child stay on track developmentally, and for families to settle down from emergency mode. Diabetes management needs to become a routine part of daily life and, while it does indeed add extra steps and requires vigilance on your part as a parent, childhood should still remain a time of play and exploration. Diabetes management becomes incorporated into childhood and family life, rather than squeezing childhood into diabetes management. In my first article on this topic, I discussed many of the initial reactions parents feel when they learn their child has Type 1 diabetes, and how important it is to keep asking questions, seek and accept support, and manage your stress level. Now, let's talk about keeping your child on track developmentally:
- Try to maintain the same expectations, values, and goals for your child. Every family has their own beliefs and standards, and the goal is for you to work to gain comfort following the same path you would even if your child did not have diabetes. Of course, this means taking extra precautions, establishing even clearer communication with others, and being available for emergencies and problem-solving. But, it also means planning to eventually include whichever of the following you would have otherwise, such as: planning play dates, eventual sleepovers, class parties, attending camp and/or school, participating in sports and other extra-curricular activities, using babysitters, etc;
- Participating in these kinds of events and activities helps your child stay “on track” developmentally and keep pace with his/her peers. In all likelihood, this means you will need to make connections with other parents, teachers, and coaches. You will need to explain what it means to have diabetes, help teach and mentor others to be good allies and caregivers for your child, and show others that it is manageable.
- Diabetes in young children is often a frequently changing landscape. What works well one week may not work so well the next. Flexibility and adaptability is a key stress management tool.
- Watch your own internal dialogue. Are you a good coach to yourself, or are you giving yourself guilt and blame messages. Nip these in the bud. Remind yourself what a good job you are doing with so many new tasks.
- If you find you are still anxious and/or depressed a few months after your child’s diagnosis, seek support from a qualified mental health professional, preferably someone who has some experience with diabetes management. These professional resources can also be very helpful if your child is anxious or about needle sticks from BG checks and insulin injections.
- Make sure you are finding time to keep yourself healthy. This is good role modeling for your child, and necessary so you can continue to be a good caregiver.
- Bed-wetting, complaints about hunger, temper outbursts, and night-time awakenings can be related to blood sugar levels that are not under control or they may be related to your child’s age and developmental stage. This is what makes diabetes management somewhat challenging in young children and why it is so necessary to check your child’s blood glucose levels as prescribed by your doctor, and to also stay in close touch with your diabetes care team.
- There will be many requests made of you early on that will not last forever. Middle of the might blood glucose checks are one example. Parents can become very anxious and exhausted. Keep the lines of communication open with your healthcare provider. Share the burden with your spouse or partner. Things will settle down. Try not to remain in emergency mode indefinitely.
- Friends and family members are likely to have misconceptions of what Type I is, how to treat it, and what causes it. Include others in your educational classes wherever possible. Breathe deeply and stay calm- remember that they are learning too. Clear up bad information. This is likely new for everyone. Look for simple reading material or YouTube videos, etc; to clarify and to help train others. Make it social and consider hosting a diabetes party to teach other parents in your neighborhood how to help your child. Use your Iphone and/or computer to help train and coach other caregivers or provide them with video or online support if you cannot be at home with them. Seek out a parent mentor to talk to through one of the local advocacy groups.
- All children need to have healthy boundaries and understand limits. Learning to deal with frustration and calm themselves down is a developmental task. However, having blood sugar levels that are out of control will significantly impair this ability. Having diabetes means you need to always check blood sugar levels first and treat them if necessary, but then address problem behaviors in an age-appropriate way, and make sure to model good stress management skills yourself. As with most things, prevention is key- so teaching good coping skills when your child feels well and providing positive reinforcement for good choices, will also go a long way.
None of the above is intended as specific advice for your situation. Every child is different and a personal assessment is necessary. Be sure to speak with your healthcare provider with any specific questions about your circumstances. Referencing of resources, individuals, and organizations is not an endorsement, and is for informational purposes only.