I’ve been pondering lately how differently diabetes is viewed through the eyes of a child versus an adult.
I think one of the best illustrations of this divide is in determining which diabetes task is the most onerous. When James was diagnosed, we were introduced to two types of sharps: He needed a finger prick to test his blood sugar, and he needed a needle stick to give insulin. Which one did he find scariest? The shot. Every time the shot. The finger pricking device has a lancet that emerges so quickly it can hardly be seen. As it goes right into the very sensitive pads of the fingers, I personally find that it can sting for a long time after testing. I would prefer shots every time. But for little kids, being able to SEE that insulin needle — even though it’s so thin and goes right into subcutaneous fat and is usually not very painful — is scarier and more dreaded.
There are other ways that I’ve observed my son processing his diabetes differently than an adult might. He finds it more of a hassle to be told that he must eat something that he bolused for, than to have to put off eating something for a time. I’ve worked really hard to always allow him to eat what he’d like to eat, so I’m glad that’s working. But I didn’t always realize how irritating it must be to have to eat carbs to match an insulin dose already given.
James prefers his insulin pump to his CGM (continuous glucose monitor). For me, although I love both pieces of technology (so much!!), I think the CGM was the real game-changer. While I was glad for having a pump to get variable basal rates and administer tiny amounts of insulin, shots were also effective for us. But for James, he really relishes that he doesn’t need to stick himself with syringes several times a day. By contrast, I love that I can see his blood sugar all day long, whereas testing at scheduled times never really bothered James. I wonder if he’ll feel differently once he’s an adult?
Our feelings about out-of-range blood sugars differ as well. My experience with kids with type 1 is that although they don’t love feeling low, mild lows do bring some consequences that they don’t mind so much! James has told me that he prefers being low to being high. Whereas I’m always worried about the immediate consequences of low blood sugar and the potential impairment it can bring, according to James, feeling high feels pretty awful. He’s getting better about noticing and expressing that now as a teenager. On the other hand, he gets candy and juice to treat lows. What can I say? That one seems like it might be universally appreciated!
I think one of my takeaways from all of this is to be mindful that children don’t see and feel things just the same as we do. There is always individual variation, of course, but I also think that fundamentally, kids and adults have different levels of worry based on their very different developmental stages. Knowing this serves as a caution to me not to rely too much on my own feelings as a parent. Whenever I can and however I can, I check in with my son about his fears, his preferences, and his hopes and aspirations. Taking the time to talk helps me to understand him better, and I think it helps me know what he most needs in his diabetes treatment. Doctors provide the medical insight, but trying to empathize with what he’s feeling helps me hone our routines, our attitudes, and all the supportive aspects of care that make his life better in so many ways.
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.