Imagine sharing with a person you’ve just met that you have an incurable disease, with symptoms that can come on suddenly and can sometimes be critically serious.

Now imagine that you’re a kid and it’s the first day of middle school, and fitting in is possibly your biggest, if not only, concern in life right now. How awkward and embarrassing it can be to be so, so different.

Talking to friends about type 1 diabetes can be a major hurdle for kids. But it’s not only a social challenge — it’s also a key safety issue. Kids spend an increasing amount of time alone with their peers as they grow older, which means it’s a good idea for friends to know the signs of a problem.

How comfortable a child may be talking about diabetes to friends usually depends on her personality, says Korey K. Hood, Ph.D., associate professor of pediatrics at the Cincinnati Children’s Hospital Medical Center.

“Some kids kind of wear that diabetes sign openly, and they don’t mind if anybody knows. For them, it’s pretty easy to talk about it. For some kids who tend to not talk about it as much or disclose it to other people, it may be because they haven’t actively accepted it yet,” Hood says.

Asking for help from others can be part of what might make discussing diabetes an emotional issue. “My son doesn’t want to bother people because he’s so laid back,” says Marisa Schmidt of Fairfax Station, Va. “I don’t think he has a problem telling others he has diabetes, but he sometimes has trouble telling them that if he says he needs something, he really needs it right now.”

Hood, the author of a book for teens on managing diabetes, has a two-step plan to help kids with type 1 diabetes feel comfortable talking to friends about it:

1. Come up with some scripts in advance.

Having a set answer ready for any kind of situation will help a child feel confident that he knows how to phrase things so friends will understand. Parents can help kids think of the kinds of questions friends might ask, and how to answer them. The scope of what is communicated can vary according to a child’s personality. For those less comfortable with the subject, it may be simply facts-as-needed: “I have diabetes, and I have to give myself this shot,” or, “If you see me looking sick, let the teacher know.”

As your child gets to know friends better and is more comfortable, details can be added — maybe about how insulin controls blood sugar or how he can still do what other kids can do.

2. Practice saying the scripts at home.

Parents can help by role-playing potential dialogues, especially with younger children. Pick a quiet time to practice when there is relatively little stress, rather than putting your child on the spot. It may help to emphasize the practical aspects of sharing information for those reluctant to speak out.

“We tell them, ‘Think of how not telling people will get in the way of those things you want to do,'” Hood says.

Schmidt agrees: “I sat my son down and said, ‘I know you don’t want to be different. I know you want to be independent. But there are times you are going to need help, and you need to tell people about that.'”

A key part of role-playing is also modeling sensitive social interactions yourself, Hood says. “For example, there are plenty of parents who will just roll into a school or classroom and say, ‘My child has diabetes; this is what you have to do.’ A better strategy might be to say, ‘This is the information that needs to be communicated to the staff, and this is why.'”

Sending your child to camps and social events where she will meet other kids with type 1 diabetes is also a great way to help her get used to openly discussing it. The longer she waits to talk about it, Hood warns, the greater her anxiety may become. The good news is that once tackled, the issue typically becomes a normal part of a diabetes care routine.

“The hardest part is usually the first disclosure, and pushing kids over that hump to make it. Then it becomes a little bit easier,” Hood says. “I always tell them, ‘It’s never as bad as you think it’s going to be. If you just directly go at it, and be a little nonchalant, it tends to go just fine.'”

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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