Q: My 12-year-old son was invited to go on a weekend ski trip with his friend's family. This involves much more type 1 management than just a one-night sleepover. How do I know if the parents can handle this? Should he go?
A: As I so often remind parents of preteens, there are many different types of 12-year-olds; some are mature and responsible, others less so. Add type 1 diabetes to the mix, and these differences in maturity levels tend to become even more apparent.
So, ski weekend or no ski weekend? At the top of your readiness checklist should be your son's ability to serve as the go-to person for diabetes during the weekend away. Is he able to manage care routines on his own with some oversight from another adult (i.e., remembering to check blood sugar levels, counting carbs, administering insulin, recognizing and treating lows, checking ketones, etc.)? Of course, we don't promote this regularly; kids with diabetes who are expected to do too much on their own too soon often fail because, well, kids are kids. But in this case, if he is capable of being in charge of his diabetes for this weekend -- with supervision from his friend's parents -- then you may be one step closer to making your decision.
Next, take into consideration how on-board the friend's parents are with helping out with diabetes management. Talk to them and find out what they're willing to learn and do. If the parents seem reluctant or in any way unwilling, this may be a deal-breaker. If the parents do want to learn, teach them the "survival skills" of type 1 management; they don't need to know how to look for patterns, but they do need to know the basics of checking blood sugar levels, administering insulin, and checking ketones, and when to do it. They also need to know the specifics of how to recognize low blood sugar (hypoglycemia) and be prepared to treat it. Having readily absorbed carbs on hand is always a must, but given that this is a high-activity weekend, it will be even more important to monitor for low blood sugar, which leads to my next point: Talk to your diabetes educator or endocrinologist beforehand to come up with a workable plan to allow for increased physical activity.
It's okay to expect your son and his friend's parents to check in with you throughout the weekend, especially this first one. For many parents, hearing bedtime blood sugar levels can offer peace of mind. Whether or not you allow your son to go is entirely up to you, of course, but staying in close contact and having a solid plan in place can help make this a safe and enjoyable trip for him and an almost-worry-free weekend for you.
--Lisa M. Bolduc-Bissell, R.N., C.D.E., is a diabetes nurse clinician in the pediatric endocrinology department at Vermont Children's Hospital at Fletcher Allen Health Care in Burlington.
How Other Parents Deal
"There's a reason why unlimited texting exists, and I think it's for parents of kids with diabetes to not lose their minds when their child is away from home. When our son travels to away games for school sports, we have him check in via text with his numbers before and after the game. I have no idea how parents handled these kinds of things in the days before cell phones!"
--Kristen G., mom of David
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