Coming Back From a Low

It had been a particularly rough week for Candace’s son, a freshman in high school. Having had type 1 diabetes since he was 5, he was familiar with the highs and lows, but this time his classmates got a front-row seat as well. “He had so many lows that the school even called an ambulance,” Candace remembers. “On Sunday night, he told me that he didn’t want to go back, because everyone would treat him ‘like a freak.’”

An ambulance being called to the school. Having to walk off the field mid-play during a sports game. Stumbling or tearing up in front of everyone when a sudden low comes on. For you, the scariest part of type 1 diabetes is a severe low; for your child, it might be facing the kids at school afterward.

After a serious low, blood sugar may be back in range, but anxiety can remain for both parents and children. An (often) invisible medical condition has suddenly become very visible, and kids may naturally feel uncomfortable about all the attention and worried about how peers will respond. Will they be teased about the incident? Will teammates feel let down? Will everyone treat them differently now?

Just like you make sure your child always has sugar at the ready in case of a low, you can help her prepare for the emotional ups and downs by making sure she has the right social coping skills in her pocket as well.

Choosing the Right Words

Helping kids rebound from lows begins with creating a healthy emotional relationship around type 1 diabetes. For young children, “this can start with something as simple as changing from saying ‘I have diabetes’ to saying ‘My body has diabetes, and I need to manage it to feel well,’” says Maureen Healy, Ph.D., a clinical child psychologist. “This is a way to help your child recognize she’s bigger than this diagnosis or any low. Diabetes is just part of what she has to deal with in everyday life.”

Children can also benefit from knowing they’re not alone in struggling with big issues. “Emphasize to your child that among their peers, everyone is dealing with something, whether it’s their parents getting a divorce, a serious allergy to peanuts, or another situation,” says Healy. “Everyone has something they need to accept and do their best to manage.”

Getting Attention When Needed

Managing lows quickly and efficiently can help keep them from turning into major incidents. So Healy suggests kids develop “scripts” of exactly what they can say and do when they’re feeling low.

“For example, if your daughter starts to feel low at school [and she needs to leave an activity to eat a snack and perform a check], she could say, ‘I’m not feeling 100 percent and I’m going to take a break now.’ Or simply, ‘I need to take a few minutes and get my body feeling better.’” Using these kinds of neutral phrases can give children a greater sense of control over what’s happening.

Kids should also know the difference between lows they can handle on their own — by excusing themselves to go eat a snack, for example — and lows that will need more assistance (e.g., when they’re feeling shaky).

“Go over these situations with your child so she knows how to get a teacher or adult’s help in getting what she needs… whether it’s access to her medical bag or low supplies, or something else [like calling the nurse],” says Healy.

Rebounding After a Low

On the way back to the classroom or playing field after treating a low, children might be worried about awkward questions from classmates or teammates asking why they needed to leave or why the nurse had to get involved.

To calm these anxious feelings, Healy recommends making stress management and relaxation an add-on part of treating a low. “I encourage parents to learn a relaxation technique with their son or daughter so they can practice together, get calm, and then your child can learn to do this on their own when they need it. For example, a breathing exercise is perfect for calming… or you can use an audio app to learn calming techniques.”

When kids are in a calmer state of mind, it’s easier to answer questions from friends, or even get out ahead of the curve by saying something to a classmate like, “Hey, I’m feeling better now. What did I miss?”

When her son was younger, Candace used her beginning-of-the-year class visit to talk about type 1 diabetes as a chance to model for kids how to respond after a low happened.

“During ‘the talk’ about type 1 and lows in September, I realized how useful this time was to go over what happens after the low is treated… that your child will come back to class when ready and will just want to get back into the activity, so there’s no need to say or do anything special. His classmates totally got that. Even if a kid doesn’t have type 1, they still know that feeling of not wanting to stick out.”

Your child can also count on something else to ease their worries: short attention spans. That Monday after the ambulance incident freshman year, it turned out Candace’s son had nothing to fear. “Not a single person mentioned anything, and there were no funny looks. They had all turned their attention to the more pressing matter of who was asking whom to the winter formal,” Candace recalls. “I think we both learned that day that self-absorbed teens with short attention spans can be a good thing sometimes.”

Stopping Bullies

Some children may unfortunately experience bullying because of their medical condition, and that is never okay. “Some signs of being bullied may include your child isolating himself, tearing up, saying not-so-nice things to himself, looking depressed, and being fearful about sharing his medical situation,” says Healy.

The best and most direct course of action to stop bullying may take teacher involvement, alerting school officials, and working with the administration to ensure your child feels safe and supported at school. You might want to volunteer in the classroom to see what’s happening and create opportunities for your child to spend time with friends outside of school as a way to build a strong support network. Connecting your child with a therapist can also be helpful.

At minimum, you want your child to know that treating a low blood sugar is never something to feel bad about. Being able to take care of a low — and knowing how to ask for help — are skills your child can be proud of.

“Your child needs to learn that we’re all different and there’s nothing — not one thing — to be ashamed of in having a medical condition,” says Healy. “Sure, everyone can have a bad day. But if someone makes fun of you because you’re different, they’re not your friend. Your friends are nice to you and have your back.” Especially through the lows.

 

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.

 

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People in the Know: Embarrassed by a Low
People in the Know: How to Handle Bullying
People in the Know: Detention for Low BG?

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