Helping a Child With T1D Navigate Social Situations

As a parent of a child with type 1 diabetes (T1D), it is only natural that you are anxious that your child is safe and is empowered to make healthy decisions for themselves when they are away from you. After all, it is your job to keep your child safe, and when it comes down to it, type 1 diabetes adds another layer of complexity to the already formidable responsibilities of being a parent. In the long run, as your child grows up, they will learn to independently manage their type 1 diabetes and setting rules now will lead to good habits later. 
 
If your child is a teenager, they may be defiant or dislike if they don’t have a say in creating plans to manage their type 1. They may have concerns or objections, and it’s important that you hear them out fully and respectfully. After all, your child knows their experience with the disease better than anyone. 
 
Have discussions with your growing child and make discussions about diabetes management a collaborative process. Listen to how they feel about their stressors, their concerns and their resistance to your suggestion and offer solutions that help you reach a common ground. Make it clear that you are listening to how your child feels but be upfront about the importance of developing good diabetes management habits—know that by taking disease management seriously, you’re setting a good example for your child follow. Remember that his or her safety is your common goal. 
 
From after school activities to parties and social events, here are some common situations you might set rules around and ideas for how to handle them. 

Setting Rules Around Extracurricular Activities 

Being a part of a group—be it a player on an athletic team, a cast-member of a play, or anything else—is a commitment to the entire team. Remind your child that when they are healthy, they can be at their best. And when they give their best to their extracurricular activity, not just them but their team succeeds too.  
 
It’s fair for you as a parent to set up guidelines with your child, such as requiring routine blood-sugar and/or continuous glucose monitor (CGM) checks before practice and after he or she gets home from school or ensuring that your child has supplies and treatment for lows packed in their backpack or gym bag at all times. If your child is doing a physical activity like playing soccer or going to a dance class, talk with them about managing their blood sugar levels after a workout. 
 
You can set rules to play as well. Discuss the ideas with your child and come to a mutual agreement on what seems reasonable and appropriate. Of course, acknowledge that there will likely be some not-so-perfect episodes—when this happens, work with your child to problem solve. Diabetes is not easy, and you don’t want your teen to resent it even more if he or she goes through a hard time. However, if your teen falls into a pattern of not managing their disease responsibly, you may decide that they need to temporarily scale back on extracurricular activities, at least until their diabetes is under control. 

Setting Rules Around Parties and Sleepovers

As a parent, the thought of your child attending a party or sleepover may be daunting or make you uncomfortable. Your teen will be out of your care for an extended period of time, and while you don’t want to deprive your teen of a fun social invitation, you also know that you need to keep them safe.  
 
For parties, be sure your teen checks their blood sugar late into the party or after getting home. Snacking at parties is common, and you really cannot expect your child to count out chips into their own bowl at a party. Instead, work through how to come up with a plan for next time. For starters, you might suggest that your child set a phone timer as a reminder of when it’s time to check. 
 
It is also possible that your teen will attend a party where there is alcohol present—it is important to talk to your teen in advance about alcohol and its effect on blood sugar, and how to stay safe while drinking with type 1 diabetes. Whether or not they are planning to drink, and even if your child is under the age of 21, make sure they know the basics of partaking in alcohol with type 1: 

• Always drink after eating, or while snacking on foods with carbs and protein  
• Check blood sugar frequently, before during AND after having an alcoholic drink 
• Wear your medical ID at all times and make sure your friends know what to do in an emergency. In case of a serious low, glucagon may not work and 911 will need to be called. 

Sleepovers are a different scenario. If you are comfortable letting your teen stay over at a friend’s house, make sure that the friend’s parent knows that your teen has type 1 diabetes. That person will be a by-proxy diabetes caregiver and letting them know what the signs of an emergency are will allow them to act if a serious low were to occur. 

Give your teen the option: they can tell the parent, or you can. From there, set goals for your teen for the night and see how they do. You can follow your child’s CGM to (discreetly) monitor their blood sugar and make sure they stay on track. It’s hard to let go when you’ve been in charge of their diabetes care since the time of diagnosis. But remember that your goal is to raise a confident, happy, independent person who just so happens to have diabetes. Small steps like these will allow your child to feel confident to manage their disease.