What are some of the tools that your child can use to thrive with T1DM? They consist of the coping skills that he may or may not know he possesses. These are the traits that you want to promote by constantly emphasizing them. Praise the child when he does the right thing for his diabetes, whether it's eating properly, taking the injection correctly, or exercising. Also remember to limit the criticisms for mistakes.
WEfl To your child, you represent the chief "judge" in his life. If you constantly reinforce the positive qualities that he possesses, that's how he'll think of himself. On the other hand, if you dwell on his negative qualities, he'll see himself in that light.
Some of the key tools for helping your child deal with T1DM include the following:
^ Let him be the one in control of his diabetes. As much as your child would like to have his parents, doctor, or diabetes educator handle things for him, he's the one constantly making the important decisions as to what to eat, how much to exercise, how much insulin to take, how much to rest, and so forth. (Of course, if your child is too young to make such decisions on his own, it's your job as parent or caretaker to step in.) It's important that an older child have the knowledge he needs to make the right decisions. This book is a great start to gaining that knowledge, but you can also help your child talk to his doctor, diabetes educator, pharmacist, and other helpful folks to find out the info he needs.
^ Focus on his successes. When managing T1DM, you and your child know that there are times when things go better than other times. Try to figure out why that happens and use the knowledge to improve his diabetes management. For example, summer may be approaching and your child wants to be in good shape for summer sports, so he's willing to exercise more. When he increases his exercise level, he may find that he needs less insulin to get good control of his blood sugar and blood levels. You and your child can work together to develop an exercise program to maximize the benefits of exercise regardless of the time of year. (See Chapter 9 for full details on exercise.)
^ Get the family's help. T1DM is a family disease, which means that a supportive family can really improve your child's control of his diabetes. For example, if family meals aren't consistent with your child's needs, it's harder for him to control his blood glucose. If a sibling encourages him to eat things that he knows are problematic, the sibling isn't doing him any favors. And things can be just as difficult if the sabotage is less direct, like if family members constantly complain about how he manages his diabetes. As the parent, you and your child can work together to let other family members know exactly the extent to which you want them to be involved in the diabetes. I say much more about this in the next section.
^ Develop a positive attitude. A little optimism can go a long way. You will find as you read this book that there's an enormous amount of work going on to cure your child's diabetes. Some of the best brains in the world are concentrated on doing this. But even before "the cure" is found, your child should know that he's blessed by having the best set of tools that has ever existed to control his blood glucose.
In the decade and a half since researchers studied the benefit of glucose management in preventing or slowing complications from T1DM (see the sidebar "The Diabetes Control and Complications Trial" in Chapter 5), the knowledge of diabetes treatment has expanded with new tools and tests. Someone may announce the definitive cure tomorrow. In the meantime, a positive attitude helps your child keep his diabetes in the best possible control so that he's ready when the cure is available. Pessimism only leads to an "I don't care" attitude that doesn't motivate him to do all the things he needs to do with regard to his T1DM.
^ Help your child identify the most difficult issues and figure out how to overcome them. Remember that every problem has a solution. For instance: Does your child have trouble remembering to take his insulin or do his blood glucose tests? Meters are now available with alarms that he can set to remind him (see Chapter 7). Because he generally tests just before he takes his insulin, one alarm may solve both problems.
Is he having trouble figuring the correct insulin dose, perhaps? His doctor and dietitian can be of help. Learning how much insulin he needs for the glucose in his blood (see Chapter 10) as well as the carbohydrate he's about to eat (see Chapter 8) will solve this problem.
^ Don't expect perfection. Although things need to go right most of the time, there will be times when they don't. So many different inputs determine the result of your child's blood glucose that even if he eats the same food, exercises the same amount, and takes the same amount of insulin each day, his next glucose level may be very different from what he expects. If this happens consistently, a change may correct the problem. But if a surprise is a rare event, encourage your child to forget about it. One or even several bad blood glucoses won't damage him in the long run.
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