Q: Our 11-year-old daughter lied to me several times about her blood sugar readings. When I confronted her about it, she said she lied because "I always get mad at her" when she goes high or low. I admit that I have nagged her when she has off readings. How should I respond -- and should I hold her responsible for lying?
A: As children with type 1 diabetes navigate their way toward adolescence, it's normal and healthy for them to assume more control over certain aspects of their care. During this transition, however, there are bound to be some bumps in the road -- for both of you.
First, let's look at your daughter's actions. While some preteens with type 1 are ready to take on a more central role in their diabetes management, many kids at age 11 still require close supervision. Are you sure your daughter knows when to test and how to respond to certain numbers -- by eating carbohydrates when there's a low, for example? Is she only responsible for testing when she's out with her friends, or does she now self-test during the school day?
Because the two of you have hit a snag, think about sitting down with your diabetes educator to work out what level of self-care is truly best for your daughter right now. The diabetes educator can also answer any questions your daughter may have about testing and test results and provide some quick brush-up lessons in checking blood sugar, if needed.
This is also where your response comes in. I know it can be incredibly difficult for parents to balance allowing their child more independence without resorting to nagging when glucometer readings are off track. It may seem impossible at first, but work toward removing the emotion from blood sugar results. For example, instead of immediately asking, "What did you eat?" when you notice a high, first ask your daughter how she was feeling and how she responded before following up with what she thinks could have led to the high. Remember, it's not just food! Exercise, illness, and other factors completely out of your daughter's control can affect blood sugar levels.
A simple way to hold your daughter accountable for self-checks is to review her glucometer every evening and continue the dialogue regarding her activities and other factors that may have influenced her blood sugar that day. And don't forget to follow these steps even when her numbers are just fine. If your daughter begins to detect what helps her have good blood sugar management (for example, eating regularly spaced meals and snacks even when she's busy with friends, drinking fruit juice if she feels a little light-headed, etc.), she will become better equipped to care for herself in the years to come -- no nagging required!
Finally, it may be helpful at this time to schedule an appointment for your daughter with the family therapist or psychologist assigned to your team -- and for the two of you to follow up with a joint appointment. Psychological support is critical for anyone managing a chronic illness, and meeting with a therapist is a great way to facilitate effective parent-child communication, something that will be oh-so-important as your child becomes a full-fledged adolescent.
--Jennifer Dunford, R.N., C.D.E., is a certified diabetes educator and type 1 diabetes management team member at Nemours/Alfred I. duPont Hospital for Children in Wilmington, Delaware.
How Other Parents Deal
"I've struggled with nagging, and I talked to our diabetes educator about this. She reminded me of the times when I was in total control of everything -- what he ate, dosing, etc. -- and he still had a high or low. Did I do anything wrong? No. I try to think about this every time I want to ask, 'Why didn't you test, check your pump, have a snack, etc.?' Instead, I make myself say, 'Let's review your day.' This seems to be working."
--Jennifer, mom of Evan
Disclaimer: The information in these articles is not intended as medical advice. Families should check with their healthcare professionals regarding individual care.