Growing up with Diabetes

Developmental
Characteristics

Diabetes-related
Responsibilities

Things To Try

Lots of rapid developmental changes and inconsistent behavior

Trust is developing toward parent/caregiver(s)

Experiences sense of safety and trust from predictable routines

Starts to see themselves as own individuals

Begins to assert control

Depends on parent for diabetes management

Child can develop behavior problems (e.g., screaming, hitting, running) that delay diabetes management and take up a lot of time

Build routine around shots/ glucose checks, which may include planning something fun to do afterward

Offer some choice (e.g., prepare plastic bags with a serving of different foods from which child can choose)

Developmental
Characteristics

Diabetes-related
Responsibilities

Things To Try

Demonstrates mastery with lots of new skills

Focuses on self, and here and now

Thinks concretely (e.g., good vs. bad, right vs. wrong)

Very curious about discovering new things

Growth is especially significant as child enters school system

May think that diabetes is punishment for their doing something bad

Challenges can arise in maintaining consistency across multiple caregivers and school personnel

Child involved in management (e.g., chooses site for glucose check and/or shot)

Can tell you when hungry and begins to recognize low blood sugars; help them label these feelings. Parents can speak with different caregivers on a regular basis

Developmental
Characteristics

Diabetes-related
Responsibilities

Things To Try

Can understand another’s point of view and is aware of time

School and peer interactions play an important role in life (e.g., sports, sleepovers)

Taking on more family responsibilities (e.g., chores)

Signs of puberty emerging

Parents can share some responsibilities (e.g., child can do blood sugar checks, make food choices, count carbs, give some shots)

Different issues can arise in school as child may not want to miss too much class time and risk falling behind

May express bitterness about diagnosis (e.g., “this isn’t fair”)

Onset of puberty can complicate management

Might burn out and avoid aspects of care if owning too much responsibility

Child can assume some responsibility while parent is closely monitoring (e.g., check blood sugars and count carbs)

Child can track times for snacks and recognize lows

Help child express feelings about diabetes (e.g., with words, drawing, writing, etc.)

Parents can discuss with child difficulties that might be coming up and model use of active problem solving strategies

Testing in the classroom can relieve some school-related issues

Developmental
Characteristics

Diabetes-related
Responsibilities

Things To Try

Thinking more about own personality/identity

Managing significant body image changes

Negotiating peer acceptance

Spending more time alone with peers and showing greater independence (e.g., drivers license)

Peer pressure can play big role in drug/alcohol experimentation

Teen assumes most of responsibilities, although parents still need to be involved on a daily basis (e.g., looking at logbook, etc.)

Negotiation of diabetes responsibilities can create family conflict (e.g., tug-of-war between independence and dependence)

Regular exercise and healthy diet can be very rewarding (e.g., need less insulin)

Management can present challenge to body image (e.g., pump visible)

Life stressors can impact diabetes control (e.g., school and/or peer problems)

May take more risks with diabetes (e.g., missed insulin shots; refusal to log sugar levels)

Open communication between teen and parent, and active problem solving, can help reduce conflict

Active stress management strategies (e.g., relaxation, drawing/writing, exercising) can help teen prevent worsening of metabolic control, sleep problems or other symptoms of depression

If teen feels supported with diabetes care, will be less likely to burn out, feel overwhelmed by responsibility and engage in unhealthy behaviors