When children with type 1 diabetes (T1D) become teens, parents must balance the fast pace of high school with new social activities and more independence. Sound impossible? It’s certainly not easy, but it can be done. Read an extract from JDRF’s Teen Toolkit, with some useful strategies for parents on coping with those high school years.
As your child with T1D gets older, they will spend more time in and around school. In fact, for teens involved in extracurricular activities and sports, school time can take up as much as ﬁfty percent of their weekday. That means a comprehensive and smart plan for how to deal with T1D at school is a must-have tool.
Engaging with the school
It is essential to involve the school when your teen has T1D. Australian schools have a responsibility to provide a safe environment and adequate supervision for your child and most schools will work closely with the family to ensure that your teen adheres to a treatment plan. This may include staff training, insulin, test strip and hypo kit storage, sharps disposal and a private space for injections and testing. Regulations for how schools manage students with T1D are different in each Australian state so you will need to check with your local Department of Education.
As a parent, you are responsible for informing the school of your child’s diagnosis and providing the school with your diabetes management plan. It may help to connect the school with your healthcare team to ensure a smooth process. Ensure that the school’s emergency contacts are up-to-date.
TOP TIP: If your teen is sporty, you might like to make a special visit to the school sports department to ensure they are aware of the situation.
Schools are NOT obligated to assist with the delivery of T1D medications. Unfortunately, you may also find that some schools are not particularly proactive about supporting your teen’s T1D management. In this case, you may need to take an active role yourself or look around for a school that is more in line with your needs.
Mobile phones can be important tools for managing T1D, especially if using a CGM. It is likely you will need to negotiate mobile phone access for your teen at school, as many have a ‘no mobile’ policy. Make sure you have this discussion with school administration and ensure that information is passed on to teachers.
Sports, band, drama and other out-of-school activities
Being a part of a group, be it for sports, music or anything else is a commitment to the entire team. It is your child’s duty as a team member to do their best. With T1D, this means trying to stay on top of what is going on T1D-wise. It’s fair for you as a parent to set up guidelines with your child, such as, a check before the practice. Just make sure you are reasonable about them and do allow for some not-so-perfect episodes.
One way to keep a teen on track and safe is to reinforce how much blood sugar control (or lack thereof) can impact performance. Be it on a stage or a sports field, in a pool or on a track, people with T1D perform better if blood sugar levels are within a certain target range.
For the first weeks of any sport, you may need to ask (or beg) your teen to check a few more times than usual and experiment with things like bananas, lollies or juice. Acknowledge that it may be annoying but will pay off when they are able to perform at their best. Of course, always make sure your child has glucose, a monitor and insulin at any event.
The newly diagnosed teen
Whilst your family might need time to get the hang of new treatment plans, your teen will often want to return to ‘normal’ life quite quickly. This can pose some challenges as both teens and parents get used to the routine of T1D management.
You may find that your formerly academic teen starts to let their homework slip following diagnosis. Your socially active teen may become a little isolated. This is normal in the first stages of T1D but should be addressed if it continues for a long period of time.
Adding in new routines to already complex timetables can be tricky. Encourage your teen to use aids like mobile phone alarms to remind them to test, bolus or inject. As your teen get used to counting carbohydrates, you might like to include small stickers on their lunch and recess with the carb counts for each item. If they buy food from the school canteen, it’s simpler to choose foods ahead of time so they can plan their bolus accordingly.
From a social point of view, your teen may be reluctant to share their new diagnosis with their friends and peer group. They need to understand that the more people know, the less of a big deal it is.
TOP TIP: Every Australian high school has access to a school counsellor, you may like to consider this service should your teen continue to struggle socially.
The teen with established type 1 diabetes
Starting high school is a good time to re-evaluate your T1D management plan to incorporate the different requirements of high school. You may need to change things like blood glucose testing times to fit in with new class timetables. Work with your teen, the school and your diabetes team to come up with a new plan that ensures the best possible management with minimal interruptions to the school day.
In addition to the normal fluctuations seen during adolescence, these timetable changes may have some effects on HbA1C measurements. Encourage your teen to keep a daily diary for a few weeks so you can compare activities and food intake with blood glucose measurements.
Of course, students who have had T1D for many years may enter high school yearning for new freedom. You need to emphasise how important daily diabetes management is to their long-term health whilst being understanding when things go a little awry.
Did you find this article helpful? This was an abridged extract from JDRF’s Teen Toolkit. Download your own free Teen Toolkit, for plenty more information on bringing up teens with type 1 diabetes.