Every parent of a child with type 1 diabetes knows that a day will come when that child must take complete control over their diabetes management. This can be a scary thought for some parents. They see their teen more interested in the latest fashion and music than they are about possible future health problems from out-of-control blood sugars.
Though there is no set formula for when a child with diabetes is ready to take over full management of his or her diabetes, here are a few guidelines parents can consider.
Age of the child at diagnosis
Of course, the younger the child, the less likely the child is able to adequately understand or practice consistent diabetes management. But, in general, a child diagnosed between the ages of 8 and 12 should be able to participate in some ongoing diabetes tasks, such as loading the test strip into the meter, using the lancing device and applying the blood sample to the test strip.
Though it may seem like a simple task that only needs to be shown and practiced a few times, younger children in this age group may need a lot of parental coaching and supervision for an extended period of time before they can be expected to perform these tasks unsupervised.
By the age of 13, most youths who have lived with their diagnosis for at least several months should be able to perform most, if not all, of the tasks associated with their own diabetes management. This again does not mean that they no longer need parental oversight or accountability.
The next factor often determines their suitability for taking over this task earlier or later in their developmental process.
Level of emotional maturity
Unfortunately, a child’s emotional age does not always match his or her chronological age. A 14-year-old, who should be able to perform all of the diabetes management routine may not have the emotional maturity to make good judgments about when to check blood sugar or how to adjust an insulin dose for an unexpected amount of food. The assessment of whether child has this ability is largely determined by parents and also may be influenced by observations from your child’s diabetes healthcare team.
This assessment of emotional maturity can also be seen in other areas of the child’s life. If, for example, the child uses mature judgment in a situation at school or in relation to one of his or her younger siblings, then it can reasonably be assumed that he or she can apply that same maturity to their diabetes management. If in doubt, give them some additional responsibilities and see how they respond to these tasks over time.
When a child shows less emotional maturity in judgment than what should be expected at his or her age, it is important to assess what they are capable of doing and let them do that. For example, they may be able to test their blood sugar and draw insulin with competency. But their ability to adjust insulin doses based upon variables such as food, exercise, sickness, etc. may seem too risky based on their approach. Once this is determined, the parent can expect the child to perform the tasks they are capable of but not the ones that need more emotional maturity to practice safely.
It should also be mentioned that diabetes is best practiced with a team mentality. That even when a mature teen can competently manage his or her own diabetes, it never hurts to consult others when there is a question. Diabetes presents many dilemmas that need skillful problem-solving and that is best accomplished by talking over the options with another family member or someone from your diabetes healthcare team.
Family support system
A final consideration for knowing whether it is time to turn the management of diabetes over to your child is the state of the family relationships. A supportive family environment where communication is honest, respectful and open is much more likely to foster mature judgment and responsible diabetes practice by the child with diabetes. In contrast, families characterized by poor communication, lack of respect and ongoing disagreements are more at risk for inconsistent or undisciplined diabetes management.
When a family environment is chaotic and unsupportive, it is better to have one or both parents supervise the diabetes management of the child until it is clearly evident that he or she has shown that they are capable to perform the tasks day in and day out with sound judgment.