In This Chapter
^ Establishing goals for diabetes care ^ Explaining how to test blood glucose and deliver insulin ^ Working together to buy and prepare food ^ Exercising and traveling as a family ^ Sharing in household chores ^ Having fun with educational video games f
È nvolving children in their own diabetes care is critical. Sooner or later, as a parent or caretaker, you have to give up your control of food, injection amount and timing, blood glucose testing, and all the other tasks that are required for good diabetes care. When you do so, you want to know that you're turning over the care to a highly qualified individual, your child with T1DM.
Before you turn over the care, you can do a lot to prepare your child by letting him participate in what you do for him. Start by asking for his ideas and views about how you take care of his diabetes. Be sure to listen to what he says and show that you take him seriously by turning his reasonable suggestions into reality. This collaboration will have many benefits for your child, including the following:
1 It will increase his self-confidence.
1 It will improve his communication skills.
1 It will expand his knowledge as you discuss his ideas and why they're appropriate or not.
1 It will make him ready to take over his diabetes care when you think the time is right.
294 Part V:The Part of Tens
This chapter covers ten ways that you can progressively involve your child with T1DM so that he's ready, willing, and able to care for himself.
Your child probably doesn't know if he wants to be a doctor or lawyer at the age of 8, but by this time, he may have an idea of how to handle his diabetes. If not, this is a good opportunity to discuss the subject with him and to really listen and learn. You'll quickly find out how he feels about having diabetes — whether it's a major burden on him and if he's coming to terms with it. You also may find out what he's willing to do for himself and whether you need to keep charge of his diabetes until he's more reconciled to it.
If your child doesn't have goals for his diabetes care, this is a time to set some with him. You can start by asking the following questions:
1 When does he feel he can start doing his own blood glucose testing and administering his own insulin? (I discuss these tasks later in this chapter.)
1 Does he understand the consequences of not taking good care of himself, for example, eating right and exercising? (I talk about the importance of good food and regular exercise later in this chapter.)
1 Is he willing to share his diagnosis with other family and friends so that they can help when necessary? This should be done when the diagnosis is first made because their help may be needed even more at the beginning than later on, after you and your child have a better understanding of diabetes care.
These are all important issues. The way he manages them will determine if he'll earn a Joslin medal for diabetic longevity in 50 years (see Chapter 17 for more about this award).
Unfortunately, at least at present, testing blood glucose means sticking your finger. And that can hurt, although modern testing devices (see Chapter 7) keep the pain to a minimum. As soon as your child has good hand-eye coordination (around age 7 to 10), start letting him stick his own finger for blood glucose testing. Remember, he may have to do this for the next 50 or 60 years. He needs to find out how to produce a drop of blood with little effort, to get the test strip ready for testing, and to get the blood on the strip with minimal effort.
Doing his own testing will give him a lot of confidence about his diabetes. You want to emphasize the key role that testing plays in the management of his diabetes and the significance of the numbers that appear on the monitor. The more willing he is to test, the better his diabetes control. And the better his control, the fewer complications (if any) he'll experience later in life.
The short-term benefits of letting your child do his own glucose testing also are clear. He'll always be on top of his blood glucose, and ketoacidosis (high blood glucose) should be unusual. Hypoglycemia (low blood glucose) should be rare as well because he'll know in advance when his glucose is dropping. (Flip to Chapter 4 for more about hypoglycemia and ketoacidosis.)
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