Monday, November 10, 2014

Preparing My 10 Year Old Daughter with Type 1 Diabetes to Manage her Disease Independently

We did it! My 10 year old daughter, Madison, who has type one diabetes went to the movies, the park and out for pizza without anyone educated or trained (just prepped) in her disease for the very first time! And I learned a lot from this experience.

First, I learned that Madison needs to understand that when she eats, it takes about 2 hours before her blood glucose will start to go down. Of course there are exceptions to this rule such as she is running around. Typically when a child with type 1 diabetes eats, their blood glucose will go up and peak about 2 hours later and then start to go down and stabilize.

Yesterday, Madison called me after the movie to let me know that her blood glucose was 323. She had eaten lunch at Noon. Then she ate candy at 1:30 pm with a blood glucose of 256. Her blood glucose still hadn't peaked from lunch. So eating more sugar with a higher blood glucose will make her blood sugar go up higher. The 323 was expected. I told her give it an hour and her blood sugar will start to go down. She felt a lot better after she called me.

Second, I should have educated her friend's dad on who to call for an emergency such as 911 and me! I think it's also important to be aware of the Glucagon pen. It's like an Epipen and used if a person with type one diabetes experiences hypoglycemia and passes out.

The following is how my husband and I are preparing our daughter to become more independent. This is a life threatening disease and it isn't easy for us to let her go out an entire day without us.  For me to feel comfortable, I need to know that she is responsible enough to take care of a disease that has life threatening results if not managed properly.
  • Prepare her medical / diabetes bag. In Madison's bag, we always have the following:
    • Meter including finger pricker and test strips
    • CGM (if she's not wearing it)
    • Two 4 oz juices
    • Container of Ritz peanut butter crackers
    • Wipes to clean her fingers for an accurate testing
    • Glucagon pen (for emergencies)
    • Ketone strips
    • Parents and doctors (endocrinologist) numbers
    • and sometimes Glucose tablets. These don't work as fast for Madison, so we hardly use them.
  • Check her blood glucose using a finger pricker, test strips and meter
  • Administer insulin using a wireless meter, her pump and/or shots. We've just required Madison to know how to administer insulin using her pump because that is all she uses.
  • Understand what to do (and how it feels) if their blood glucose is low (hypoglycemia). Every child is different, but when Madison is low - below 80 - she needs a 4 oz juice and a few peanut butter crackers. 
  • Know what to do (and how it feels) if their blood sugar is too high (hyperglycemia). 
  • Be able to test for ketones using ketone strips.
  • Know that when their blood sugar is too high they shouldn't be eating carbs. They can still eat non-carbs (cheese, meat, celery, cucumbers, pickles). Once their blood sugar goes down to a good number (we like 180), they can have a carb again.
  • Have a phone readily available. We let Madison borrow her brother's phone so she didn't have to keep asking her friend's dad. She texted me a few times and then called three times. It gave her peace of mind that I was there if she needed me. When we spoke, I had her answer her own questions versus me giving her the answers.
I would love to hear other ideas or suggestions for how to continue helping my daughter become more independent!


  1. I have a 15 year old with T1D. She was diagnosed at 10. It can be tough to let them do their own thing but you have to let it happen. I think it is overkill to ask her to be competent on 18 different bullet points before she can go out. No kid can get it all right. There has to be an element of taking responsibility and trial and error.

    We have never asked any friend to know how to give a glucagon shot. The only direction we give is to call 911 and then us if a crisis presents. The last thing we have wanted is to limit our daughter's friend pool if a parent won't learn how to give a shot. The only people we've trained on shots are her swim coaches (25 hours a week in the pool) and her grandparents.

    The hardest part of T1D is learning to give up control. Dictating what they can eat, when they can eat, who they can see will only create resentment. We bought our daughter a cell phone the day we got home from the hospital. We have plans for her sleepovers, week long swim camps, and nights out. It was hard at first but it gets a lot easier.

    I could write a book on all the research we've done, especially on elite level athletes and T1D. So, don't think we just let her run wild. But, we found it important to emphasize her independence the day after the diagnosis. And, that confidence will enable her to be more independent.

    1. It isn't easy parenting a child with type 1; especially one that is into athletics. My daughter plays basketball and competitive fast pitch and soccer. We've learned a lot over the past three years... especially about the Adrenaline Effect. On another note, I totally agree with not spooking the parent out (definitely don't want to do that), but this disease also shouldn't be taken lightly. A parent always let's me know if their child has a severe life threatening allergy where they require an Epipen. I think it's my responsibility to let them know that Madison has a Glucagon pen, that we've never had to use it, but it is in her bag with instructions in case of an emergency. She'll be doing her first overnight type 1 diabetes camp next summer.

    2. Oops! Sent before I was finished. We haven't done sleepovers, where she's slept over a friend's house yet. But we will be doing a t1d overnight camp next June. Can't wait! Thanks so much for commenting! I would love to hear any tips you've learned about t1d and athletics and also puberty. My endo keeps warning me about the later. Wishing you happy holidays! Melissa