To say that there is just one age at which a child learns how to take care of type 1 diabetes is like saying that there is one age when a child learns math. It seems to be a gradual process, one that is unique to each person. Some children learn to read, write and tie their shoes well before they enter kindergarten, while other kids struggle with these things well into first grade or after. Gaining independence with diabetes care is also a very individualized process, but I have found that there are several major milestones to work toward.
- Eating Your Food and Only Your Food. The first thing that little ones with type 1 diabetes need to learn is that everything they eat affects their blood sugar. They need to know that they can’t eat food without telling Mom or Dad. No more sharing food at the lunch tables at school. No sneaking snacks from the cupboard. At first, Evan and I made sure to keep a very watchful eye over Kaitlyn, but pretty soon after she was diagnosed, we expected her to be independent enough to know that she needed to ask to be dosed for food that was offered to her. Also, if she doesn’t end up finishing her meal, Mom and Dad need to know.
- Checking Blood Sugar. Thanks to the encouragement of Kaitlyn’s fantastic school nurse, she began learning to test her blood sugar pretty quickly. She now checks her blood sugar herself most of the time. She is gradually getting better at knowing what those numbers mean as well. She knows her target number and her in-range numbers.
- Giving Insulin. This is one that we’ve only barely begun. Knowing when and how much insulin to dose is a job that I will not completely give to her for a long time. However, she can begin the mechanics of it by practicing which buttons to push on her pump in order to deliver the insulin that the pump calculates. We have a friend with type 1 who is a couple of years older than Kaitlyn, and she has done very well with learning how to operate her pump. Her mom always tells her how many carbs to enter, and she can do the rest. This is our goal for Kaitlyn as well. Eventually, she will need to learn how and when to give insulin via her pump independently as well as how to draw up insulin into a syringe and give herself an injection.
- Counting Carbs. This is by far the most difficult task to master. Even as an adult, I am continually learning and trying to get better at it. Although it will be many years before Kaitlyn will be able to look at a plate of food and estimate how many carbs to dose, we can start small. She already knows what kinds of foods are “free.” We’re also working on teaching her how to read labels and figure out carb information based on the serving size and total carbohydrate count.
There are many other things to learn, like how to handle emergencies or low blood sugar episodes, site changes, and proper ways to care for insulin and supplies, etc. However, this list of major milestones is a great start for us to begin to work toward.
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.