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Living With Diabetes
"Your child has diabetes..."
The
first reaction to these words is shock. And with
shock, the realization that the diagnosis of diabetes
mellitus will change your child's life, as well
as your own, forever. Suddenly, there are new
responsibilities, new restrictions and new fears.
The presence of a life-threatening disease complicates
already complex relationships between parents
and child, and brothers and sisters. Inevitably,
the physical disease will impact on the child's
psycho-social development.
You
wonder, "Can my child grow up emotionally
and psychologically healthy?" The answer
is, yes! But there is no denying that diabetes
makes it tougher. In fact, one of the unique difficulties
of diabetes is that it requires self-care.
Children don't just receive treatment, they have
to learn to be their own nurse. They need to constantly
monitor their blood sugars, watch what they eat
and schedule exercise programs, all of which require
a high level of discipline.
This
article is designed to help you understand some
of the more common psychological, emotional and
social developments you may encounter in bringing
up your child. The more you understand, the greater
your success in achieving your goal--raising a
happy, healthy, productive child.
Young
Children and Diabetes
Diabetes
may not be so obvious to young children. They
may not understand the sudden changes in their
lives, including painful procedures like insulin
injections. Looking for explanations, they often
believe they are being punished for disobedience.
They may feel ashamed and guilty. Sometimes they
show hostility toward their parents, feeling that
somehow, their parents have failed to protect
them properly. Mom, who used to guard them against
pain, now inflicts pain or forces the child to
self inflict pain. Since children think their
parents are all powerful they may believe you
can make the diabetes go away. A child can't grasp
the reality of the long-term complications that
you as a parent understand.
Managing
Childhood Diabetes
One
of your most important jobs as the parent of a
child with diabetes is to supervise, encourage
and foster the independence it takes for a young
person to successfully manage his or her own condition.
When
parents are overprotective they undermine the
child's self-estemm. Instead of developing a feeling
of mastery over his or her own environment, the
child develops a "sickly" self-image.
The child may use diabetes to exert control. They
may use low blood sugar reactions as a means to
avoid unpleasant activities...or let high blood
sugar develop to a point of crisis.
This
point cannot be overstated: you must get your
child involved in self-care as soon as possible.
Self-care is the key to the development of a child's
independence and self-esteem.
Encouraging
Independence--Building Self Esteem
Use
Positive Reinforcement
-
Rewards Instead of nagging or scolding, which may cause
a child to lie or become evasive, try using
a reward system to build good habits. Make a
chart that shows things he or she should be
doing every day and place a value on each. When
a certain number of "stars" are earned,
your child can cash in those stars for a special
reward.
- Praise Praise your child for new habits. Don't punish
him or her for lapses, but rather, focus on the
opportunity to "try to get it right tomorrow."
- Choices Avoid choices that require yes-or-no answers.
If the child must eat a snack, ask if he or she
wants to eat one type of food or another. Questions
with "no" answers provoke conflict.
Teenagers
and Diabetes
Adolescence
is a tough time for all kids (and their parents).
For teenagers with diabetes there are extra burdens.
Hormonal changes actually aggravate diabetes--making
good blood sugar control hard to achieve.
As
the parent of a teenager with diabetes, be prepared
for the worst. That child who was always so good
about diabetes procedures may suddenly rebel against
the routine. He or she may refuse to monitor blood
sugar levels... go on food binges. ..fudge test
results. Your teenager may be grumpy, angry, distant.
Even when your child tries to be conscientious,
blood sugar levels may swing up and down eratically.
Psychological
Developments
- Achieving
Sexual Identity--To develop a sexual identity,
a person has to accept his or her own body. While
this is difficult for all teenagers, diabetes
makes it even harder. After all, in movies and
on TV, successful people are shown as young, beautiful
and physically perfect. Teenagers with diabetes
know they're not perfect. They wonder if they'll
be accepted by the opposite sex--and by their
peers. Sometimes, fear of rejection will cause
teems to isolate themselves from their peer group.
But isolation is even worse for their self-esteem.
If you see this happening to your child, you should
get involved and try to break this potentially
damaging cycle.
- Becoming
Independent--One way that teenagers achieve
independence is by forming bonds with their peer
group. But peer groups require confomity and that
creates conflicts for teenagers with diabetes--how
can they act just like their friends (for instance,
stopping by the local pizza parlor after school)
and still keep control of their diabetes? Adolescents
are expected to become totally self sufficient
in their diabetes routine. While their blood sugar
levels go out of control--in spite of their best
efforts--they may feel frustrated, weak and inadequate.
They may react in one or two ways: denial of the
diease, by going on food binges and skipping their
insulin, or with aggressive behavior.
Physical
Changes
One
of the most frustrating and persistent problems
during adolescence is the inability to control blood
sugar. New research has shown that physiological
changes are at work. It is believed that a hormone
called Growth Hormone (GH), which stimulates the
growth of bone and muscle mass during puberty, also
acts as an anti-insulin agent. Moreover, when a
diabetic teenager's blood sugar drops, it stimulates
the release of adrenalin which in turn triggers
the release of stored blood glucose. The result:
blood sugar levels that sway from too low to too
high.
It
is important that you and your teenager realize
that poor blood sugar control is not "all his
or her fault."
Guidelines
For Getting Through the Terrible Teens
- Understand
the Need for Spontaneity--A teenager wants to
be spontaneous--to be able to do things, eat things,
try things spur of the moment. Diabetes requires
the opposite. A teen with diabetes must realize
that freedom only comes with knowledge. Only by
fully understanding and controlling his diabetes
can a teen achieve the flexibility he craves.
- Understand
the Need for Control--Teens want to be masters
of their own life. They want to define their own
identity. In order to do this, they have to keep
testing their limits. You can help show how they
can use the discipline and control of diabetes
care to gain strength and mastery in other parts
of their lives.
- Recognize
the limits of your Control--Be realistic. Accept
the fact that you can't watch over your teen every
minute of the day. You, too, have to learn that
it's your child's diabetes, not yours. This doesn't
mean you should turn your back on your teen and
allow him or her to self-destruct. You can talk
to your child about the choices he or she is making--and
let them make as many of the decisions as possible.
Talk about grown-up matters, like career, marriage,
alcohol. Not only does this provide valuable information,
it shows that you regard your teenager as an adult.
- Offer
Access to Support Groups--Get your child involved
in diabetes support groups--such as camps--where
he or she can meet other teens with diabetes.
If you feel your child is in serious trouble,
don't be embarrassed about seeking professional
help.
Get
Involved In Support Groups
There
are many support groups and diabetes organizations.
Get involved. You're not alone in your struggle
and there's no reason to feel that way. Your child
can benefit from being around other kids who have
diabetes, and you can benefit from sharing information
and insights with other parents who know the pitfalls,
frustrations and anxieties of a life with diabetes.
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