Now that James is a certified teenager, he no longer needs me to do all of the care that goes into managing his type 1 diabetes. He tests his own blood sugar and operates his insulin pump. He’s great at doing those tasks and many others now. And that makes it easy to forget that he does still need some adult help at this point. Until I get a reminder.
The setting was a lovely hike in the mountains of our beautiful state. I was with my sister, and she wanted to take my older two kids on a gorgeous and slightly rigorous hike while I took the younger kids down to the lake to fish. I did a quick survey of James to make sure that he had some supplies on him. I made sure he had a glucometer with test strips and a lancing device and a source of sugar on him. He also happened to have his CGM (continuous glucose monitor) on him. So with that I just sent him on his way! Sounds like I was pretty prepared, right?
And I was. Sorta. But then about two minutes after they’d left, the CGM triggered an alert to my phone, which in and of itself was sort of miraculous since we were pretty far from civilization, and I didn’t expect to be able to get a signal. It was telling me that James’ blood sugar was dropping fast. That’s when I realized that I had given my sister exactly zero information about how to help James if he did have a low blood sugar incident while he was on the hike.
Thankfully my cell phone signal was still strong, and I immediately called my sister. Through the magic of 21st-century technology, I was able to give her the information I ideally should have given her before I sent the two of them up a mountain.
I told her that James knows how to do all the diabetes tasks, but he still needs reminders about when to do them. I emphasized that while he’s hiking his blood sugar might drop pretty quickly and that she might need to be on alert to look for that. If she isn’t sure, James can tell her if he’s low, either by checking his CGM or by actually testing his blood sugar. He also knows what to do if he’s low, but he needs reminders to make sure that his blood sugar is in range before they start moving again.
Basically, I was telling my sister that she’s kind of on the hook to make sure that if anything looks out of the ordinary, she employs James to make sure that he does what he needs to do.
After a very brief conversation, I let them go (again).
It turns out that they didn’t make it all the way to the top of the hike, and James’ blood sugar had something to do with it. Despite going through all of his sugar supplies, his blood sugar continued to drop. But that wasn’t the only reason they turned back. As my hikers went further, they encountered adverse weather conditions. Taking the two issues together, blood sugar and worsening weather, they decided they’d better head down the mountain.
It was still a marvelous experience with beautiful vistas and a burgeoning sense of independence. It was also a bit of a wake-up call.
When James was much younger, the process of training other adults to care for him was pretty intense. It involved showing them how to use the glucometer and lancing device, draw up insulin, and, later, operate a pump. These are not small things to learn, but they were crucial for James’ safety when he was still too little to do them himself. And I was very careful to make sure that each person I left him with was well trained and stayed in constant contact with me.
Now James’ ability to care for his diabetes has given him (and me) much more freedom. But I have to remember that he does still require some adult oversight. And part of my job is to make sure that the adults he spends time with can help him when they need to.
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.