It can come out of nowhere: That heart-wrenching question from your child about his or her type 1 diabetes that leaves you stammering and struck with mommy-guilt:
If I'm good, can I stop getting shots? Why can't I just be like everyone else?
When you're thrown one of these curveballs, it can help to have a few thoughts ready ahead of time. "Limit your answer to mainly what your child is asking and don't go beyond that unless he or she insists on knowing more," recommends Kenneth Gorfinkle, Ph.D., consulting psychologist at the Naomi Berrie Diabetes Center in New York City. "In other words, don't make the question into more than it is." Separate your feelings from your child's feelings so that you don't overreact; if you become too drawn into his or her distress, you won't be able to help nearly as much.
As for specifics, here are Gorfinkle's suggestions for responding to a few of the biggies real moms have heard at each age.
"'If I'm good, do I have to take my next shot?'"
--Joan, mother of a 5-year-old
Try this: "You're good all the time and yes, you need to take your next shot."
Generally, even young children understand that they will have to receive shots for the rest of their lives. The feeling underneath this question, rather, is typically frustration about their diabetes treatment. It's important to separate "being good" from receiving treatment, making it clear that insulin injections are not at all a punishment for misbehavior.
"'How can I go to a birthday party and feel normal?'"
--Alyssa, mother of a 7-year-old
Try this: "You are normal, you just have an extra step to do before you can eat the cake. You can explain to your friends that your body is just like theirs, except their bodies make insulin, and yours comes from a pump or a needle."
A child with type 1 diabetes is normal in all respects except for the fact they need their insulin to come from an outside source. Beyond that, they can do almost anything other kids can do -- have sleepovers, play sports, go to camp, etc. "The more you reiterate how normal your child is, the better," says Gorfinkle. "Treating your child like he or she is fragile does more harm than good."
"'Why can't I be like everybody else?'"
--Amy, mother of a 12-year-old
Try this: "It's really frustrating, isn't it? But you are like everybody else in every other way except for this one. Is there a way you'd like to be like other kids that you're not?"
First, empathize with your child's frustration or annoyance. Often times when children ask this kind of question, what they're really saying is that they're tired of their treatment (monitoring their blood sugar, moving the location of their pump, getting injections, waiting to eat, etc.). Their question is probably not as existential as it might sound. Additionally, like most kids in this age group, your child is trying to feel independent from you, and that can be hard if they're expected to text you their blood sugar numbers all day long. What your child might be saying is that he or she needs more space or wants to be treated with more trust, respect or independence. Ask questions to find out more.
"'Do I have to tell the person I'm dating I have type 1?'"
--Rebecca, mother of a 16-year-old
Try this: "You'll have to determine if someone is trustworthy enough to share it with, and that's a big part of what relationships are about. But if you're going to be out alone with a date, that person has to know about your type 1, for safety reasons."
It's best to encourage your child to share openly, to avoid fostering shame or embarrassment about diabetes. Hiding it could also lead teens to avoiding taking necessary self-care steps on a date, like bringing supplies along and eating when he or she should. Knowing about your teen's type 1 can also help his or her dates to respond more appropriately in case of an emergency.
"'Can you just stop asking me about my blood sugar?'"
--Cara, mother of a 14-year-old
Try this: "I'm here to help you manage your treatment as much as you need. Sometimes you need a lot and sometimes, you're right, I could stand back and let you take care of it."
Teens often want to be "just left alone," and a simple question like, "What's your blood sugar?" can infuriate them. This can be the most heart-wrenching question of all, because it means you may have to address your own fears about handing over control of your child's healthcare. Consider whether you've given your child an appropriate level of space to manage his or her treatment independently. If not, you may need to offer an apology and come up with a new plan that fits your teen's growing maturity and needs.
For any of these tough questions, first and foremost, always listen more than you talk. Sometimes, what kids need most is a good ear and a good hug, more so than the perfect answer.
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.