In about six months’ time, James will be called upon to make a big decision that will affect the next four years of his life. No, this isn’t about college. Well, actually, it kind of is about college, but he’s not picking a school or choosing coursework or any of those other important choices that high schoolers generally make. He has to pick new type 1 diabetes tech!
Sometimes I am absolutely thrown by how much weight and importance are given to choices made in high school. James is my oldest child, so I don’t have personal experience in this process yet. As a parent newly observing the pressures of college and life beyond age 18, I am alarmed at how every decision my sophomore faces seems to be framed in terms of making an impact on the course of his entire future. Should he take AP history or college prep? Does he need to start studying for the SAT? How important is that A- in Spanish going to be to his prospects? Is he spending enough of his precious free time in service and leadership opportunities that will be attractive to colleges? It is crazy the amount of pressure that these young kids experience. In that way, his diabetes tech decision mirrors the circumstances that surround him.
While in some ways the diabetes decision is as important as the pre-college decisions, it is thankfully much less stressful, because the options here are all good. I was thinking about the history of life with diabetes in this modern era… we’re so fortunate to live in a time when James has choices about how to care for himself. And all of those choices can lead to good lives and good outcomes. What a blessing to live now!
Right now, James’ insulin pump is about six months away from expiring. His insurance covers his insulin pump from the time of purchase until the warranty expires. That puts it cleanly into the college era — when he goes away to college, he’ll still have this new medical device that we’ll be purchasing in six months! So in a sense, when he picks a pump, he is picking for this future period of complete autonomy. It makes me nervous (though it does not seem to cause him the same anxiety at all!).
Since the last time we purchased a pump through his insurance, lots of things in the diabetes world have changed. Just in the last few years, new things have been introduced — everything from new insulin, to new continuous glucose monitoring (CGM) systems, to new insulin pumps that are automated in some exciting ways. As somebody who has lived in the diabetes world for over a decade, I have to say that the pace of innovation is picking up sharply.
This is the first pump he’ll really choose himself. When he was first diagnosed, he was much too little to understand the features of the technology. I let him pick the color of his first pump (it was blue!). With each subsequent pump, I’ve done the legwork, and while I do want him to have opinions about his pump, I ultimately steered him in the direction that fit with what I thought was best for him.
This time I want to do it differently. He’s older now. I want him to be the pilot of his own care. I want him to see the various features and try to weigh out which would work best for him, without my heavy-handed suggestions.
It might actually be easier than I ever thought to step back. This time around the options that are available to James are amazing. He will have to decide whether he wants to emphasize ease of use, or slick features, or automation that is effective but a bit fussy. Will he even choose to stay on a pump? (I think he will.) But some find great freedom and control in multiple daily injections. That’s another choice that he can decide to make. And it really is a testament to the times we live in when I say that all of these choices are okay with me.
Yes, in the coming months, James does need to make a decision that will affect the next four years of his life. But thankfully this decision is actually pretty fun. I’m excited to watch him go through this process, knowing that in this decision, all choices lead to a good future.
Disclaimer: The experiences and suggestions recounted in these articles are not intended as medical advice, and they are not necessarily the “typical” experiences of families with a child who has type 1 diabetes. These situations are unique to the families depicted. Families should check with their healthcare professionals regarding the treatment of type 1 diabetes and the frequency of blood glucose monitoring. Jen and Kim are real moms of kids with type 1 diabetes and have been compensated for their contributions to this site.