Return to Articles Index

Diabetes Responsibilities of Children at Different Ages
By Russell Turner

Published:
12September-2005

In order to maintain good blood glucose control for our children, we parents need to be actively involved for almost all of their childhood. We know that giving our children some responsibility for their daily diabetes management is important. It is our responsibility to teach our children self-confidence, self-reliance, and self-control. Encouraging age appropriate responsibility for their own diabetes care goes a long way in instilling these values.

Children of different ages are able to take on different parts of these tasks and accept responsibility for them. It is important for us not to demand or expect more from our children than they are emotionally and physically ready to handle. We must be very careful not to expect more than they can be realistically expected to deliver. We never want our diabetic children to develop a sense of failure. This can easily lead to problems including poor daily diabetes management and self-care. Our children’s ability to manage the appropriate parts of their health will vary from day to day depending on a variety of circumstances. It is important for us to keep a close eye on this and be there to help when necessary. At the same time we should be encouraging them to gradually assume more of their own care, as they are able. We are looking to raise children who are independent in their daily lives as well as their diabetes care.

All children develop at different rates. Age alone is not a sufficient measure. You know your child best, and are in the best position to determine when they are ready to assume more of this responsibility. If we take a look at the development of different children at different stages in their lives, we can get an idea of what to expect and how to best prepare our children to grow up to be healthy happy adults.

Infant – 3 years
Of course children in this age group are not able to handle any of their own care. Parents of children this age need to check blood sugars more often because babies can’t tell you when they feel low. Because of this the acceptable blood sugar range for children in this age group is a little higher than for older children, 80 – 200mg/dl. This is a tough age because the children have no idea what is happening to them. All they know is blood tests and shots hurt. Parents must remember that testing and shots are essential for their baby’s life and get past the guilt associated with causing pain. You need to develop acceptance of daily diabetes management as a normal part of life now. Lots of cuddling and loving are what are called for here.

3 – 7 years
Children in this age group still need their parents to handle all daily diabetes management. Coordination isn’t usually developed enough at this point for tasks such as drawing up the proper amount of insulin into a syringe, never mind injecting it. Now may be a good time however for them to start to learn to sit still for tests and injections. They may also help by choosing which finger for a blood test or cleaning off the injection site. Usually by 5 to 7 years old they are pretty good at recognizing the symptoms of low blood sugar. They may not articulate it exactly but they can say things like "I don’t feel good" or "mommy my tummy feels funny". Children at this age also begin to have some concept of the foods they can eat. However, they really aren’t ready to make the proper choices. At this age children still don’t have the concept of time so they still need us to make sure the proper meal and snack schedule is kept.

8 – 12 years
At this age some children start to do their own blood testing. Many children want to start administering their own insulin as well. This is a judgment call. If your child has developed the fine motor skills and you think they are ready to try, go ahead. This is an exciting time for everyone. It is however critical that you supervise every aspect of the injection. One item to note is that at this age children have an acute sense of fairness. This is the age when having diabetes seems most unfair to them. We must listen and be aware of these feelings. Let them discuss these feelings openly whenever they feel it necessary. At this age many children are also able to make proper food choices. They may be able but they often don’t. It is during this age period that parents are most able to begin turning over more responsibility for daily diabetes management. We must remember that the responsibility they accept may vary from week to week, even day to day. This is a normal part of the development of children this age. It remains vitally important to stay involved in all aspects of your child’s daily care.

13 – 18 years
As our teenagers grow older, they gradually take over more and more of their daily diabetes management. We still need to be there for assistance from time to time. Our teens will do better if our help isn’t always so obvious but we still need to be there for them. Diabetes “burn-out" is a real factor at this age. This may last from a few days to even longer. It remains important for us to be there for help and support especially during these times. You may find teens at this age are unwilling to keep an accurate log of their blood sugar readings. One way to stay involved is to offer to keep the log daily or weekly, whatever your teen will agree to. This allows us to remain aware of how well they are managing their diabetes and to spot trends and know when insulin adjustments should be made. The one aspect that changes all of the preceding rules is when a child isn’t diagnosed until they are teenagers. Then all of the preceding wisdom goes right out the window. This is a naturally rebellious time in a child’s life and daily diabetes management will be no different. If this is the case then you may want to read Special Challenges of the Teen Years. Peer acceptance at this point in your teen’s life is the most important aspect of their existence. If their peers are supportive of proper daily diabetes management then your teen will be much more likely to take proper care and make healthy decisions. Our role as parents to this age group is like that of a catcher. We must be ready when they either move forward or slip backward in their march to adult maturity. If we continue to support, set limits, share responsibility, and love our diabetic children, we give them the best possible chance at good diabetes control during this difficult time in their lives.