Your Child Has T1D
For the individual child and the whole family, type 1 diabetes changes life. As parents of children with T1D, we know that. But we also know this: Type 1 diabetes may change your family’s life, but it needn’t become your family’s life.
First, we want to assure you, emphatically, that your child can lead a full and normal emotional life with T1D. This page introduces some of the psychological, emotional, and social challenges you may encounter in raising your child or teenager with T1D.
Young Children and T1D
Young children may have difficulty understanding the sudden changes–glucose monitoring, insulin injections, food restrictions–that type 1 diabetes brings to their lives. Some common reactions among children are:
- A feeling that they are being punished for disobedience
- Feelings of shame or guilt
- Fear of death, because diabetes starts with the sound “die”
These reactions may prompt your child to act with hostility toward you, feeling that somehow you have failed him or her. Because children think their parents are all-powerful, your child may believe you can make the disease go away.
Self-Care and Your Care
One of your most important jobs as the parent of a child with T1D is to supervise, encourage, and foster the independence your child needs to successfully manage T1D. Try to avoid being overprotective. Overly protective parents undermine a child’s self-esteem. Instead of developing a feeling of mastery over his or her environment, the child may develop a “sickly” self-image, use T1D to exert control, use low blood sugar as a means to avoid unpleasant activities, or let high blood sugar develop to a point of crisis.
Teenagers and T1D
Adolescence is a tough time for all kids and their parents. Teenagers with diabetes carry extra burdens. That child who was always so good about type 1 diabetes management may suddenly rebel against the routine. He or she may refuse to monitor blood sugar levels, go on food binges, be evasive about test results. Your teenager may be grumpy, angry, distant.
The Psychological Challenges: Sexual Identity, Independence, Self-Care
Sexual identity and independence are challenges for many teens and their parents. For teenagers with diabetes, they present some special issues. The demands of self-care also can create unique pressures. To develop a sexual identity, a person has to accept his or her own body. While this is difficult for all teenagers, type 1 diabetes makes it even harder. After all, successful people in movies and on TV are shown as young, beautiful, and physically perfect. Teenagers with diabetes know they’re not perfect. They wonder if they’ll be accepted by the opposite sex and by their peers.
Sometimes, fear of rejection will cause them to isolate themselves from their peer group. But isolation is even worse for self-esteem. If this happens to your child, you should try to break this potentially damaging cycle.
To achieve independence, teenagers often form bonds with their friends. But peer groups require conformity, and conformity creates conflict for teenagers with type 1 diabetes. How can they act just like their friends (for instance, getting behind the wheel of a car without checking their blood sugar first) and still keep control of their type 1 diabetes? Helping your child feel comfortable with the boundaries of his or her T1D management program can be a positive step in dealing with peer pressure.
Adolescents are expected to become totally self-sufficient in their T1D routine. While this self-reliance helps build confidence, for some it creates another kind of pressure and anxiety. When their blood sugar levels go out of control–in spite of their best efforts–they may feel frustrated, weak, and inadequate. They may react in one of two ways: denial of the disease, or with aggressive behavior, which may be acted out through food binges or skipping their insulin.
It is important that you and your teenager understand the dynamics of blood sugar during the teenage years.
The Physical Challenge: Blood Sugar Control
One of the most frustrating and persistent problems during adolescence is the inability to control blood sugar. Research has shown that physiological changes are at work. It is believed that a hormone called Growth Hormone (GH), which stimulates the growth of bone and muscle mass during puberty, also acts as an anti-insulin agent. Moreover, falling blood sugar stimulates the release of adrenaline, which in turn triggers the release of stored glucose. The result: blood sugar levels that swing from too low to too high.
You and your teenager should both realize that poor blood sugar control is not all his or her fault.
Tips for Helping Your Teenager
Understanding and recognizing the limits of your control are key elements in helping your teenager with T1D work through the challenges of adolescence. Three areas of special importance are:
- Understand the Need for Spontaneity. Teens want to be spontaneous–to be able to do things, eat things, try things. T1D requires the opposite. A teen with T1D must realize that freedom only comes with knowledge and responsibility. Only by fully understanding and controlling his or her diabetes can a teen achieve the flexibility he or she craves.
- Understand the Need for Control. Teens want to be masters of their own lives. They want to define their own identities. To accomplish these objectives, they have to keep testing their limits. You can help show how they can use the discipline and control of diabetes care to gain strength and mastery in other parts of their lives.
- Recognize the Limits of Your Control. Be realistic. Accept the fact that you can’t watch over your teen every minute of the day. You, too, have to learn that it’s your child’s T1D, not yours.
By no means do these suggestions mean you should turn your back on your teen and allow him or her to self-destruct. You can talk with your teen about the choices he or she is making. Talk about grown-up matters, like career, marriage, and alcohol. Talking with your teenager shows you think of him or her as an adult and helps keep the lines of communication open during this difficult period.
Get your teen involved in type 1 diabetes support groups and diabetes camps, where he or she can meet other teens with type 1 diabetes. If you believe your child is in serious trouble, don’t be embarrassed about seeking professional help.
Parents and T1D
Your child isn’t the only one struggling with the emotional challenge that diabetes presents. You are too, and you need support–because it will help you and because it will help your child.
You’re not alone in your struggle, and there’s no reason to feel alone. Get involved in support groups and type 1 diabetes organizations. Your child will benefit from being around other young people with T1D, and you will benefit from sharing information and insights with other parents who know the pitfalls, frustrations, and anxieties of a life with type 1 diabetes.