Q: Our 12-year-old really wants to begin taking control of her own diabetes care. How will we know she's ready? What's a good first step toward increased independence?
A: As children navigate adolescence, it's completely normal for them to test the waters of independence. Being responsible for making sure their homework gets done? Absolutely. But assuming total responsibility for type 1 care? Not the same thing. When it comes to diabetes management, parents need to remain "in control" of the big picture, at least until their child truly becomes an adult—and a tween is just not there yet.
But this doesn't mean that there isn't room for your child to play a greater role in her care. Since your daughter has expressed interest in shouldering more responsibility, assign her some diabetes "performance tasks." While maturity level varies greatly by child, in general, kids can be taught to perform finger sticks and use a glucometer solo by approximately age 7; somewhere between ages 8 and 10, most children can start administering their own insulin injections, though supervision is still needed to make sure the dose amount is correct. Older children can also read food labels for carbohydrate information and have more of a say in food choices and putting together their meals for the day. Your diabetes educator can help your daughter learn these skills.
Much like a progress report or test grade can give you an idea of how well your child is managing her own study habits, keeping track of your daughter's blood glucose levels is an important part of gauging her consistency with these performance tasks. If your daughter is now measuring blood sugar by herself, check the glucometer to make sure readings are being performed—and that they match what she's reporting. If your daughter is now in charge of packing her own lunch, has she done a good job constructing a healthy meal? If, for the most part, her numbers are in their usual range, it's a good sign that she's making wise choices.
—Gary Scheiner is a certified diabetes educator and exercise physiologist, and founder of Integrated Diabetes Services in Wynnewood, Pennsylvania. He's had type 1 diabetes for over 20 years.
Disclaimer: The information in these articles is not intended as medical advice. Families should check with their healthcare professionals regarding individual care.