When Riley Ratzlaff went on his first sleepover after being diagnosed with type 1 diabetes, his mother, Penny, got very little sleep.
"I had concerns that he wouldn't remember to check his sugars and take insulin. I also had concerns about his sugar going too high or too low and the parent not being able to handle it. There's always the fear that he will go too low and pass out," says Ratzlaff, who lives in Merry Hill, N.C.
Basic Sleepover Requirements
There are general aspects of diabetes care management that a child needs to master before a sleepover can be considered, according to Beverly S. Adler, Ph.D., a clinical psychologist and certified diabetes educator in Baldwin, N.Y. Number one, a child needs to be able to measure his blood sugar, and number two, he should be able to administer insulin, perhaps with over-the-phone help from you.
Your child must also be able to fully communicate his or her needs to the host parents, which can be intimidating for any child. Keep in mind though, while host parents will likely be supportive and try to accommodate your child, it's best not to overly rely on them; there are too many issues that may crop up, experts say. Ratzlaff agrees, based on her hard-earned experience: "What works one minute may not work the next, and a birthday party or sleepover is hectic enough for the hosts without them also having to keep an eye on a child with type 1."
Even if you feel your child isn't ready for an evening adventure yet, try to keep an open mind toward future opportunities, Adler suggests. "If you unilaterally tell the child no, it sets up a very negative environment. It can undermine a kid's self-esteem if he or she is not permitted to join peers. Kids may feel ashamed of having diabetes or may become resentful of being 'different.'"
So if you have to say no, do so gently and give a concrete reason to help your child frame his or her future goals. "A parent could say, 'I like your friend, but we're not ready yet, because you need to master blood sugar testing,'" Adler says.
The Trial Run
Staying half the night is one way to ease into the experience. Holding a sleepover at your own home is another way you can give your child a test run. You can also introduce some of the foods your child is likely to encounter at a sleepover—pizza, chips, candy—at your own pace, so he can get an idea of carb counts and dosing responses.
Consider having a first sleepover at the house of a friend who also has type 1 diabetes, as her parents and guardians will be better able to assist in case of a problem, Adler suggests. (Don't know any other kids with type 1? The benefits of children meeting others with their condition aren't limited to sleepovers. To find opportunities for making new friends, go to the JDRF website, ask your diabetes management team about local groups, or attend one of the Friends for Life conferences held across the country by the organization children with DIABETES®.)
Talk to the host parents to be sure you're able to keep in touch throughout the night, both with the sleepover hosts and with your child. Use technology if it's available; many children phone or text their blood sugar numbers to parents. A quick video chat can be helpful, too. But try to keep calm if you get news of a blip. It's best to chalk it up to a learning experience without blaming your child, Adler says.
"A big problem can be the reaction of the parents on the other end, because the parent says, 'Why are you so high?' and it starts to be accusatory. That can lead to kids not testing, or lying about results," she says.
"You have to give your child some space, and you have to trust that your child will do the right thing. But even if they don't, the line of communication has to remain open."
A Step Toward Independence
Ratzlaff discovered this on her own during Riley's second outing. "He ate some cookies and didn't take insulin for them. We had a long talk about that, and I told him he would get another chance," says Ratzlaff.
As nerve-wracking as it may be, a sleepover can be an enticing, rewarding and important first step toward a child learning self-management of his diabetes—and for mom in learning to relax.
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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