So in the past eighteen months, James has really progressed in becoming more self-sufficient at handling diabetes management tasks. He’s gone from the kid that didn’t want to even try to test himself to preferring to enter all of his numbers into his insulin pump and even to manipulate the buttons on his continuous glucose monitoring system. It has been a marvel to watch. So much progress has been made in such a little time. I suppose it reinforces my belief that if we don’t push our kids into self-reliance too quickly, they will eventually amaze us at how rapidly their knowledge and capability improve. James is entirely self-motivated.
That isn’t to say that I don’t need to do anything anymore. I still do lots for James. I still do all the sensor insertions and change all of the infusion pump sets. I do lots of carb counting and monitoring, even though he is getting so much better at that. But the biggest thing that I still do for James is help him with his follow-through.
While he is technically capable of handling almost every aspect associated with insulin administration for a meal, he still needs me to help remind him. He can test himself before the meal, but often forgets to. I’m here to tell him he needs to. He can count the carbs in most of his favorite foods. I’m even happy for all the math practice it provides for him! He’s gotten good not only at memorizing the numbers of carb grams but at adding them up in his head and dividing them when he decides he only wants a portion of a serving.
But he often loses track of how many of something he has eaten. I’m there to make sure he has a back-up memory source. He loves to enter the carb info into the pump itself. What can I say? The boy loves his technology, so he actually prefers to be able to do it himself. But even when I help and verify the carb count with him, he might forget to enter it into the pump. I am working on reminding him and asking him, “Are you SURE you just entered 18 carb grams into your pump? How much insulin did it give you for that?”
Sometimes, because he is handling more of the tasks, he’ll end up with high numbers after a meal. Usually it’s because, somewhere along the line, James forgot to do a step. It isn’t that he doesn’t KNOW the steps, rather that he just isn’t paying close enough attention. This is where I try to be more vigilant at stepping in and verifying that every part of the meal has been accounted for. While I’m discouraged when James’ blood sugar is high, I’m delighted that it’s because he’s practicing taking care of himself. I don’t know that James will ever acquire the skills he needs for self-management if he isn’t ever allowed to make mistakes. It’s one of the most powerful tools for new learning. This is certainly true in diabetes!
For now, though, I need to fight the urge to “relax” while taking care of James at meals and remember that although he is now doing a lot more during mealtime, he still needs some supervision! I’m not sure when his own sense of responsibility will click in. I’m imagining that, similar to his progress in being capable of handling diabetes tasks, the responsibility component of self-care will progress rapidly, probably when he is finally motivated to do so.
In the meantime, I’m enjoying my newly independent James. It’s nice to be able to ask him to test himself or give himself insulin and watch him do it. I’m hoping for independence not merely because it lessens my workload, but because I know it’s part of the maturation process he needs to be a successful teen and adult with type 1.
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.