Q: I'm having problems with my 12-year-old son and his refusal to test his blood sugar during the day. Even if his teacher checks up on him, we're fairly certain he's just showing her old numbers on his meter. We've taken away his computer and cell phone privileges, but nothing changes. What can I do?
A: All we want to do is keep our children safe, so I absolutely understand your frustration -- and as my daughter enters adolescence, it's becoming clear that this stage is full of complexities that will make navigating the challenges of diabetes much more difficult.
It sounds like your son needs some help figuring out how to keep himself safe during school. Given that testing is a matter of personal safety, it's clearly not negotiable. Perhaps start by having a conversation with your son that could begin with the simple question, "How can we make this work for you?" Asking an empowering question can keep those all-important lines of communication open. In this case, you're empowering him to help solve the problem while acknowledging that the current situation is not working for him or you or his teacher. You may need to ask some follow-up questions to engage your son in the conversation. For example, "Where are you expected to test your blood sugar right now at school?" "Is there a better place or a way to make you more comfortable when you do test?" "Would reminders be helpful or would you prefer that your teacher not ask you about testing throughout the day?"
As you sort through these answers, brainstorm with your son about what a new testing routine might involve. Instead of checking his blood sugar in a corner of the classroom, perhaps testing could be shifted to the nurse's office where there's more privacy. If your son is expected to test just as everyone is packing up to go to their next class, maybe you could find a different window of time so he's not feeling rushed or like his day is frequently disrupted by the need to test. Truthfully, the question is not whether or not he will test, but when and where he will test.
One way to help your son get back on track might be to have him check in with the nurse's office for the next three days to test his blood sugar there. You can also check his meter after school to make sure testing happened. If all is well at the end of three days, see how he does on his own with the new plan and continue to check his meter at home. If he reverts to missing blood sugar checks, let him know that it's back to the nurse's office until he is willing to manage his blood sugar checks independently.
The good news is that much of the strife over testing is likely tied to your son's burgeoning sense of independence, which is an appropriate part of his development into adulthood. While you're working together to figure out the logistics of a revamped testing plan, don't forget to go over the basics of why testing is so important in the first place. Checking his blood sugar and responding to highs and lows is actually what helps him stay independent. If needed, making a solo appointment for your son with your diabetes educator may be a great way to reinforce this message.
--Stefany Shaheen was the chair of the JDRF's 2011 Children's Congress and has a 12-year-old daughter with type 1 diabetes.
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