James won't test himself. He just won't. Not at my gentle nudging or at the encouragement of the school nurse. Not despite the fact that his younger cousin IS testing herself (with supervision) and doing a fine job of it. He just isn't interested and really, I'm okay with that. At least for now.
When James was first diagnosed, obviously I did everything for him. Every finger stick, every injection, every carb count was performed by me. Not much has really changed yet. James has since grown in his knowledge of how diabetes works. He can add and subtract and count higher than his blood sugar (thankfully) will ever get. He understands which number is high and which number is low, how to treat the low, that the high needs insulin, and that he needs to be tested regularly throughout the day.
The fact remains that he will need this kind of care for the rest of his life. Certainly when he leaves the house to go to college, he'll need to know how to do all the things that I am currently doing for him.
As I see it there are two elements crucial to helping him learn to take over his diabetes care. First, there is the knowledge itself. Managing diabetes on a daily basis will take some math skills, some scientific understanding, a bit of financial savvy and some fine motor competency. While it seems like a lot to know, I'm sure that when he is truly interested in self-care, I'll have the time to impart this knowledge.
The other aspect that will be perhaps even more important and more difficult to instill is a sense of responsibility and emotional maturity that will allow him to cope with dealing with a chronic illness. He'll need to be able to have the discipline to do routine blood sugar tests, count every carb consumed, and to always give himself insulin. He'll need to have the wisdom to ask for help from his friends and roommates when he is dealing with low blood sugar and to ask for the advice of medical professionals when needed. He'll need moral strength to overcome discrimination or to combat prejudice. He'll need a good sense of self-esteem to get past the days that might be discouraging and an unwavering resolve to stay positive.
So, to me, the diabetes knowledge is such a tiny portion of what will ultimately help him to care for himself. Right now it is my assertion that forcing him to test himself before he feels ready will undermine some of my efforts to instill a positive attitude toward diabetes. I'm sure from the outside it looks like I'm avoiding my responsibility to teach him self-care. The truth is I'm trying to carefully lay down the foundation for emotional resilience, enforcing positive habits and healthy eating and routine testing. I'm allowing him to learn about responsibility through school work and family chores. And I'm ultimately trying to shape his character to become the grown-up man that will care for diabetes day in and day out in a healthy way.
I'm confident that the day will come when James will no longer want me to test him (at least most of the time) and he will yearn for more responsibility. I'll be right there to teach him. In the meantime, I figure I'm working behind the scenes, doing the best I can to help him become the kind of person that can handle diabetes on his own.
About the author: My name is Jennifer, and I live in Southern California with my husband, Craig, and our three boys. Our oldest son James has been diagnosed with type 1 diabetes. I'm thankful for this opportunity -- along with my sister-in-law Kim and her daughter Kaitlyn, who also has type 1 diabetes -- to share our struggles and triumphs with our friends in the diabetes community.
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.