With Thanksgiving on its way, you'll soon be congregating with far-flung family members around a big table full of seasonal delicacies like pumpkin pie, turkey, stuffing, and all of the fixings. For families of children with type 1 diabetes, it's a great time to educate relatives and dispel myths, says juvenile diabetes expert Jennifer Miller, M.D., a pediatric endocrinologist at La Rabida Children's Hospital in Chicago, Illinois.
"It's important that they know the basics about type 1," Miller explains. "With adults, go over what to do if blood sugar gets too high or too low, so they'll know how to react in an emergency situation," she advises.
Talking to younger kids about type 1 diabetes is a different story. Registered dietitian and certified diabetes educator Marlisa Brown suggests, "For younger children, try something like: 'Your cousin is the same as always. He got sick (but it's not contagious or 'catching'), and now he just needs to take something to help keep him well. If he looks like he doesn't feel well, he could have taken the wrong amount of his medicine, so tell his parents or yours right away.'"
Thanksgiving is also a great time to clear up any misconceptions they might have about diabetes. "So many people think that children with type 1 can't have pumpkin pie, which is simply not true," says Miller. "They just have to take enough insulin to cover the carbs. Now's a good time to teach people the facts."
It's also nice to have a private chat with relatives before the holiday so they won't unknowingly make your child feel uncomfortable at the meal. "Let them know that you don't want your child to feel different if at all possible," Brown advises. "After all, Thanksgiving should be a time of joy, not stress. A child with type 1 diabetes can eat anything as long as it's in moderation. If it appears a child is eating something they shouldn't, ask others not to call out and say, 'You have diabetes—you can't have that!' Explain that all foods can be incorporated into your child's diet if planned. For instance, sometimes a piece of cake will give the same effect as stuffing—and it's something that you and your child have gone over with your doctors and are prepared for."
Moderation is key, so relatives also shouldn't pressure children with type 1 into eating larger portions. "Kindly ask those who are known 'food pushers' to refrain from encouraging your child to eat more or saying something like: 'Try a bigger piece of my coconut cake!'" Tell relatives that bigger portions affect the amount of insulin you have to give, and bigger is not always better.
What do you say to nosy relatives who are overstepping their boundaries despite your requests? "Nicely but firmly say you appreciate their concern and help, but you have it covered," advises Brown. "Explain that your child is seeing an endocrinologist (a doctor who specializes in illnesses like diabetes) as well as a diabetes educator and registered dietitian, and that you have worked out ways your child can have some favorite foods."
As long as family members are educated on the basics beforehand, Thanksgiving can be a joyous holiday for children with type 1. And that's definitely something to be thankful for!
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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