As teens with type 1 diabetes grow more independent, it’s a given that new plans for self-care will need to be put in place. And that can seem simple enough on the surface — you agree that your daughter will check her blood sugar regularly while at her after-school job, or that your son will make sure his dates know about his type 1. But if you’re like most parents, what keeps you up at night is all those other little what-ifs — what if she feels a low coming on and doesn’t want to tell her boss? What if he ends up at a party where there’s alcohol?

Helping teens with type 1 transition to adulthood is one area where focusing on the what-ifs in life can actually pay off. It’s called scenario planning — talking through various possible situations and scenarios so that you and your child can agree on solutions in advance. “We have these role-playing conversations with families and kids a lot,” says certified diabetes educator Donna J. Marvicsin, Ph.D., clinical assistant professor at the University of Michigan School of Nursing in Ann Arbor. While they might feel awkward at first, Marvicsin has some advice on how to get the ball rolling.

First, keep your conversation age-appropriate. For example, starting around middle school, you might ask, “How will you respond if someone offers you a drink?” At this point, you’ll focus mostly on your child’s strategies for saying no. Once your teen enters high school, says Marvicsin, you may want to evolve the conversation to more specifically address the risks of mixing alcohol and type 1 diabetes.

Before you fire off the tough questions, Marvicsin recommends reviewing the facts. Say your teen wants to go to a concert with friends. Consider that dancing in a crowd without easy access to water might set the stage (no pun intended) for dehydration and/or exercise-induced lows. Then again, all the excitement of the show might send blood sugar soaring. So before giving permission, work through all the possibilities. You might ask questions like, “Given all the variables that could throw off your numbers, how often will you test your blood sugar? What will you do if outside food and drinks aren’t allowed inside the concert hall? If you feel low, do you think one of your friends would be willing to go find somewhere to sit down with you? What if they ask you to wait till the next song?” Of course, you won’t want to deliver your questions rapid-fire like this, but rather pause to listen to your child’s answers and let those guide your conversation naturally.

Other topics that are prime fodder for scenario planning include first dates, job interviews, sleepovers, summer camp or any situation you or your teen are anxious about. These can be hard discussions to have, but it’s better to tackle them together first so your child will be prepared when and if the real situations arise.

When it comes to scenario planning, Marvicsin says practice makes perfect, so pose these types of hypothetical questions again and again. “That way, when the first date or the first job interview occurs, your child has had practice with presentation,” she says. Teens will exude confidence from knowing just what to say and how to say it — because they’ve already said it to you.


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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