The preteen and teen years are a rocky time for all kids, as their social identities emerge, they start such eternally awkward rituals as dating, and they pull away from their parents to find their own sense of self and establish their independence. This is a particularly tricky time for adolescents with diabetes, who may be desperately trying to find a way to “fit in” when their blood glucose checks, insulin pump, and eating habits all say i am different.” The hormonal changes of puberty also take a toll on diabetes control in and of themselves, increasing overall insulin resistance. Girls and boys face a sea change in their bodies that makes control a bit more elusive than normal. Things will stabilize after a time. This is also an age for experimentation with drugs, alcohol, and smoking, all things that will affect your child’s blood glucose control in ways he or she is not accustomed to. Worse, drugs and alcohol can impact your child’s perception of blood glucose lows and impair his ability to make good decisions. Now is the time to have a frank talk about drugs, alcohol, and cigarettes. Your child needs to know how it will affect his diabetes, and what precautions he needs to take if he does try any of these things. Giving him this information is not the same as saying you approve of his experimentation with drugs or alcohol; in fact, he also needs to know explicitly that you don’t want him using at all. But since adolescence is often filled with bad decisions as teens try to find their own identity, educating your child for the possibility could literally save his life. Sex is another area where a candid discussion is necessary. Your adolescent needs to know about birth control, and the risks of unprotected sex in terms of sexually transmitted diseases and unwanted pregnancy. Again, you don’t have to condone it, but you do need to provide vital information.
Handling Special Days
Birthdays, slumber parties, Halloween sometimes it seems like childhood is one big food fest. It’s hard to deny your child special treats when all her peers are digging in. Fortunately, with insulin adjustments and good planning, your child can partake in some of the sweet treats of childhood in moderation.
As the only holiday devoted almost exclusively to gorging on sugar laden treats, Halloween holds a special place in hell for most parents dealing with diabetes. This can understandably be a very tough time for your child to get through, but you can make it easier. Try focusing on the real spirit of the season and make a special haunted house for the kids, or let them have a spooktacular party with ghost stories, rubber spiders, and the old “spaghetti intestines and grape eyeballs” game. For younger kids, a costume party with pumpkin painting and other activities, is always fun. If you’re hosting, you can control the quality and quantity of snacks. You can also make a game of trading small toys, books, stickers, and nonedible prizes with your kids for their sweet loot. Make each item worth a certain number of candy pieces, and they can brush up on their math skills as well. Know the carb counts of the fun sized treats and be the gatekeeper for the candy they do keep.
When a birthday invitation arrives, talk to the host parent ahead of time to find out what’s on the menu. If it’s something your child is particularly sensitive to, bring a special snack. Make sure the parent knows what amount of cake and/ or ice cream is allowed. You may have to accompany your child to most parties, even when he surpasses the age where most parents hang around. With a full list of other guests to attend to, you can’t reasonably expect the party hosts to attend to your child’s medical needs, especially if the birthday child is a classroom acquaintance and the parents are largely unfamiliar with diabetes and your child’s special needs. If attending the party becomes an issue with your child and her growing sense of independence, assure her that you’ll fade into the background as much as possible except when your help is needed. When the celebration takes place at a public venue like a skating rink or a movie theater, this is a bit easier on both of you. Think about bringing siblings and making a separate family affair out of it so you’re almost not even there. This usually works out best for all involved you aren’t hanging around, making your child feel self conscious, it gives the host parent peace of mind to know you are in the area should your help be needed, and you feel better knowing your child is nearby. Your other kids and/ or your spouse also get a day of fun out of it, so everyone wins.
The first solo sleep over can be nerve wracking for both you and the host parents. Kids old enough for slumber parties and overnight trips are typically at least starting to manage some of their own diabetes care, which helps. Spend some time with the parents in advance of the event to give them a briefing on what your child might potentially need, and make yourself available via phone for any questions they might have during the visit. Provide them with a one-page sheet with all treatment basics; trouble signs will be helpful as well.