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 is 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 pamphlet 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.
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-esteem. Instead of developing a feeling of mastery over his or her 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.
Use Positive Reinforcement
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 erratically.
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 teens 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.
Adolescents are expected to become totally self-sufficient in their diabetes routine. While this self-reliance helps build confidence, for some it creates another kind of pressure and anxiety. When 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 of two ways: denial of the disease, by going on food binges and skipping their insulin, or with aggressive behavior.
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 adrenaline which in terns triggers the release of stored blood glucose. The result: blood sugar levels that say 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."
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.
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.
Copyright © 1996 Juvenile Diabetes
Foundation International. ALL RIGHTS RESERVED.
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