Q: Since our daughter turned 12, she's become very prickly when we try to talk to her about diabetes. In essence, she claims she already knows everything about it, having had it since she was 3, so leave her alone. How can we communicate better with her? We just want to keep her safe. I can't even ask her what she ate for lunch at school without her biting my head off!
A: As children transition through adolescence, it's normal for them to want to assume greater responsibility for managing their type 1 diabetes. At the same time, however, research tells us that teens and tweens who receive little parental support and supervision tend not to follow their diabetes treatment plans, with the typical result being poorer blood sugar management.
So how do you strike a balance, especially when your child is feeling so "been there, done that" about type 1? The data we have suggest that parents must still be in charge of at least some aspects of the daily regimen and remain responsible for overall care.
As children get ready to enter the teen years, it can help to view the notion of continued parental support as the simple act of being present. Set the expectation at home that when your daughter is performing a blood sugar check or any other part of her care that she is responsible for, you must be in the room to see what she is doing. Say to her directly, "I know you know what to do, so I'm just going to watch."
What's important here is that you are empowering your daughter to feel greater control and expertise in taking care of herself, while still fulfilling your duty of making sure her treatment plan is followed. You don't need to even talk during these times unless feedback is required.
You might even want to state, "You're in control; I'm just here to make sure you stay safe."
All this may be a little trickier for working parents. But make it clear that when you are home at night, care routines happen in your presence, or at minimum, your daughter must show you her meter so you can look over the day's readings.
When it comes to struggles over lunch, try a different variation of this same approach. Instead of asking "What did you eat today?" after the fact, switch the conversation about lunch to the night before by assigning your daughter the task of packing her own lunch (or pack it together) and have her show it to you before she goes to bed. Discuss portion sizes and healthy choices when necessary, but try to refrain from nagging or judgmental comments. Or make it a nightly routine to have her read out loud to you what's available on the school lunch menu and together decide which choices might be best.
These might seem like very small changes. But when your daughter picks up on the fact that you're treating her like an expert and giving her more control and trust, while also continuing to be supportive, you may find the doors of communication are suddenly much easier to push open.
--Valerie Macy-Hurley, L.C.S.W., is a medical social worker at the Endocrine & Diabetes Center at Miller Children's Hospital Long Beach in California.
How Other Parents Deal
"My son has a planner for his homework assignments that I have to sign every night. This seems to work like a charm for making him do his homework, so why not have one for his type 1? I now have a chart at home that he signs off on when he has checked his sugars for the day. I can double check his meter to keep him honest. So far, it's 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.