Adjusting to a diagnosis of diabetes takes time and patience for all family members. Everyone will have to get used to the “new normal.” You will need to manage situations differently in many ways.
Here are some ways to effectively manage diabetes care at home.
Share responsibilities
Get everyone in the family involved. Diabetes care is a partnership between the child and the entire family. Share responsibility for the routines wherever possible. Also, get the support of others—other family members, grandparents, camp counselors, teachers, sports coaches, even regular babysitters. The more they know about your child and diabetes care, the more comfortable you will feel when they are in charge.
Sometimes diabetes seems to take up every minute of every day. Try not to let diabetes become the focus at every mealtime or discussion. Make some time for yourself and your significant other. If you have other children, make sure to have special one-on-one time with them as well. They might feel jealous and resentful at first at the attention their sibling with diabetes is getting.
It is important for you to take time for yourself and do things you enjoy such as read a book, take a walk, or watch a movie. Remember to take care of your own physical and mental health.
Your diabetes team
Make good use of your diabetes team. Feel free to ask questions. Seek support from the diabetes team, other parents of children with diabetes, or a support group to help relieve stresses, frustrations and anxieties surrounding diabetes. Children are sensitive to these feelings and may either mimic your behaviour or try to hide things from you to avoid upsetting you.
Review goals and expectations together with your diabetes team, on a regular basis, to be sure they are still appropriate. Is everyone aiming for the same blood sugar targets? Can everyone agree on how often blood sugar monitoring will be done? Can everyone agree about who chooses what foods at mealtime?
As your child gets older, encourage them to develop their own relationships with members of their diabetes team. Let your teen have private time with the doctor or nurse at each clinic visit. It is natural for parents to want to stay informed, discuss issues and be part of developing the plan for the next phase. Having your teen meet on their own with the diabetes team will prepare them for when they become adults. As well, teens should be able to expect confidentiality in their health care.
Acknowledge feelings and provide encouragement
It is normal for people with diabetes to feel overwhelmed at times or to feel like no one understands them. Acknowledging those feelings, while also providing encouragement, helps children to feel understood and supported.
Your diabetes health-care team is there to help. Talk to them for ideas or encourage your child to talk to them, either with you present or privately. The diabetes team might even be able to put your child in touch with others of the same age who have diabetes and who understand how they are feeling.
Create a routine
Creating a routine is the best way to ensure diabetes care becomes a regular part of life for your child and your family. Children respond well when they know what to expect. When you are at home, try to create a consistent approach to blood sugar checks and insulin injections. Be aware that your involvement will change as your child participates more and more in the routines. It is important to stay involved in all aspects of your child’s diabetes care throughout childhood and their teen years.
Routine in infancy and childhood
Infants and young children quickly pick up on parents’ anxieties. Try to be quick, calm and reassuring when carrying out routines.
Try to allow your child to have some control over the routine if they wish. For example, they can choose the finger for the next prick, choose their snacks, and help with insulin injections.
Be realistic with what you expect your child to take on in their diabetes care. Do not expect too much too soon. On the other hand, try not to be overbearing and overprotective.
Routine in adolescence
As your child gets older, you may need to take into account increased participation in sports or extracurricular activities, a busier schedule that might include a part-time job, and less supervisory care. As these normal changes occur, your teen will participate more and more in the diabetes care routine as they become more independent and responsible for their health.
Tips for transferring diabetes care to teens:
- Wait until your teen is ready, willing and able to take on parts of their care.
- Start small and increase gradually. Allow the teenager choice of what task they want to take part in (for example checking blood sugar levels, preparing or administering insulin, and completing the blood sugar log book).
- Be encouraging, but do not force or threaten.
- Praise your teenager freely, and look for opportunities for ongoing education when things get off track. Positive reinforcement will result in more of the desired behaviour.
- Avoid nagging your teenager if certain things are not done; instead, take the approach of helping out. For example:
- Help get the monitoring equipment ready for a check rather than saying, “it is that time again!”
- Offer to keep the logbook, rather than complaining that you do not know what is going on because the numbers are never recorded.
Be prepared to get involved in the care again as necessary. Even the most independent teen is going to need back-up during particularly stressful periods, such as a crisis in a relationship, an illness or during a time of too many competing priorities. This is not a step backward. It is just evidence of the family working together to ensure that the teen’s health is kept up at all times. If parents do not provide support or provide care inconsistently, teens tend to have more problems with their diabetes.
Taking ownership of the routine
Experiment a little and see what works for you and your child and discuss with your diabetes team for more help and options. What you learn in your diabetes education and clinic sessions provides you with an excellent foundation.
Be prepared for the occasional slip-up. As children take on more responsibility, they make mistakes—eating a little more, skipping a snack, recording a false blood sugar reading, or perhaps even missing an injection. These lapses are a normal part of growing up. Expect them and watch for them. This way you can deal with them before any serious problems arise. Remember that these lapses are not a sign of failure. Rather, they provide an opportunity to talk about diabetes and its challenges, and to open the door to creative problem-solving.
Adjust attitudes and beliefs
How families cope with diabetes depends in some ways on their attitudes and beliefs.
Those who see it as a manageable condition will cope better. Families may have a harder time if they feel overwhelmed, are not sure of their ability to cope, or are negative about the future. These attitudes and beliefs may be influenced by the families’ past experiences with diabetes.
If you are feeling this way, the diabetes team can help you and your family keep things in perspective. At first, some parents view their child as being sick or fragile. With a little time, education and experience, they soon learn that their child is still healthy.
Try not to be too concerned and overprotective. This may interfere with the child’s normal development. Diabetes should not stop children and teens from doing all the things their friends would do. It is just that extra planning is needed to ensure their safety.
Take into account emotional impact on siblings
Siblings go through the same emotions as other family members. They may feel:
- guilt that their brother or sister has diabetes and they do not
- fear that they too may get the disease, or that their sibling may become really sick
- anger that you have stopped buying treats they used to enjoy
- jealousy because their sibling seems to get all the attention.
Meeting everyone’s needs is a challenge. Brothers and sisters need to be given the opportunity to express their feelings and emotions. They need to know that they are still loved. They should be encouraged to join in the diabetes education program. This will help them feel involved in the new family reality. It will also give them the information they need to feel safe and comfortable with their sibling with diabetes.
Many parents find that spending special time alone with brothers and sisters eases the impact on them.
