What is the “Right” Age For Certain T1D Milestones?
Every week on her podcast Diabetes Connections, Stacey Simms tackles issues and news relevant to the type 1 community. In a recurring segment—”Ask the D-Moms”—Stacey speaks with best-selling author Moira McCarthy, fielding questions about their experiences raising kids with type 1 diabetes (T1D). This week they discussed what are some important milestones and things to keep in mind as children with T1D age into teens and adults. Later they touch on aspects of continuous glucose monitor (CGM) and share their thoughts on DIY Looping.
How do you respond to certain T1D milestones, and what is the “right” age for your kids to become more independent with their diabetes care?
Stacey: So let’s start with [a question] that I got from three different people with children of three different ages and it was all about when will my child be able to do X, Y, Z. And how can I make sure that I either don’t impede them, don’t push them too hard to do it right and encourage them in just the right way?
Moira: You know, it’s really interesting because when I look back on 22 years almost that [my daughter] Lauren’s had type 1, she’s now almost 28, there were so many transitional times that it’s almost like your entire life as you grow up with diabetes is transitional times. So it doesn’t surprise me that we got so many questions at so many levels.
One of the things that I learned is that it’s not the best idea to celebrate when your young children do things on their own. In other words, the first time they prick their finger themselves, you call everyone in the family and you have a celebration. And the first time they do a shot themselves, you get them a pony. And the first time they change a site, you get them a Maserati or something.
But to me that felt like the right thing to do. Years later, I learned from the wonderful Barbara Anderson… What she said to me is when we do that to small children, we’re putting them up on a pedestal, and they in their mind create expectations of how they think we want to perceive that. And then when the time comes down the road when they might not want to do those things anymore, or they might feel uncomfortable about it or be burnt out about it, they’re afraid to tell us because they don’t want to let us down. They don’t want to let us know that maybe they’re not on that pedestal. Does that make sense, Stacey?
Stacey: Yeah, absolutely.
Moira: A warning about the ages 10 and 11 and even into 12 is… It’s really easy when your kids progress a lot at that age and take on a lot themselves to think to yourself, and I believe I said these words out loud at that time that, ‘I raised my child to understand the importance and the value of taking good care of her diabetes. And she’s so responsible, I can trust her on her own.’ I’m saying at that age, no matter how much you trust them, do not let down your guard because that can be when they start to struggle… You need to have your eyes on things at least once or twice a day just to make sure that they don’t need your help or that you’re available if they do need your help.
Stacey: I wonder too, as more and more kids wear CGMs and we’ve talked about the good and the not so great. You know the downside of too much information all at once… I remember [my son] coming home in fifth grade and I would say, ‘Did you bolus for this? Cause I could see it, I could see what was going on and he would get so frustrated. And he would get so mad at himself and it was just that fifth grade tween. Their brains aren’t working the way they had been working in the past. But I wonder if the CGM could be a way to kind of keep that eye on your kid without having to feel like we’re having conversations every day or several times a day.
Moira: … If you’re 11 or 12 or 13, and things are bouncing around, I mean every kid’s different. Some kids might not mind being texted a bunch of times every day, or talking to you a bunch of times. And some parents might be able to just pull back and set themselves limits on when they can step in.
Stacey: Well, you know how I feel about a CGM. If you’re gonna use it, you need to have a conversation with the person who is sharing with you. We can talk about what age… I think age 7 is a good time to start talking to the kid about, ‘Well what do you want? What do you think?’ And put some limits in on when the parent is going to text and when the kid is going to text back. Because all those kids have cell phones now. If you’re texting all day long, that is not good for school. It’s not good for anything. I’ll go out on that limb and people can yell at me, but I think that you have that conversation with your kid. Benny and I have done that for a long time.
Do I still get nervous and freak out? Of course. I’m not supposed to text him unless his blood sugar is this number for this long. If it’s super low, I mean we have stuff in place. If he hits 55 and that alarm goes off, he has 15 minutes to text me. Or have somebody else text me before I start. I joke with him, I say, ‘I’ll call you, I’ll text you and then I’ll start driving around the neighborhood.’ We get a little silly, but you got to have those rules.