General Coping and Adjustment

Learn general coping and adjustment tips for patients with diabetes and their families.

When a child is diagnosed with diabetes, the entire family is affected. Here are some tips that are helpful as everyone adjusts to a “new normal” of life with diabetes.

• Realize that you and your child may feel many things about having diabetes over time.
  • It is OK to be sad, angry or resentful about having diabetes.
  • The important thing is that you and your child still manage it, despite your feelings.
• Your child and family should return to their usual routines and activities as soon as possible after leaving the hospital (school, sports and other activities).
• You set the tone.
  • Families do best when there is little emotion over blood sugar results.
  • Do your best every day. There will be days when it seems like blood sugars are out of range — no matter what you do. That’s part of having diabetes.
• Blood sugar results are just data.
  • They tell us your child needs more insulin, or more food, or less insulin and less food.
  • There are many reasons why blood sugars are out of range. Don’t blame anyone, think about what may have happened and talk about it.
• Include your child as much as possible in daily tasks of diabetes care. Make sure to give them tasks that are age appropriate.
• Share the Joy!
  • Both parents need to be involved in managing diabetes.
  • If you are a single parent, try to get someone else to help — even if it is just for one day.
• Listen to your child when they are upset or angry about their diabetes.
  • You can’t “fix it” or take this away, but you can listen.
• Let your child know when they do their tasks well.
  • Many parents notice when their child misses a blood sugar test, but don’t notice all the days when blood sugars are taken or logs are kept, etc.
• Keep your rules and discipline the same as they were before the diabetes.
  • Be clear on what you expect of your child in helping to take care of the diabetes.
  • Diabetes care tasks are the same as homework and other chores. They have to get done.
• Promote healthy eating for the whole family.
  • Everyone can benefit from eating a healthy meal, not just your child with diabetes.
• No matter what age your teen is, supervise, supervise, and supervise.
  • No teen can manage diabetes alone.
• Ask for help.
  • If diabetes becomes a constant battle or the focus of your relationship with your child, talk to your nurse practitioner or social worker.

Your child’s diagnosis of diabetes is a major event.

You and your child may have many reactions:

• Sadness
• Guilt
• Worry
• Anger
• Depression
• Confusion
• Fear
• Shock
• Denial
• Sense of helplessness

All of these feelings are normal. It helps to talk about these feelings.

Your family will need to adjust to life with diabetes

• Give yourself time to adjust.
• Managing diabetes is a lot of work. You need to help and support one another.
• Share the diabetes tasks.
• Identify support people:
  • Spouse/partner
  • Friends
  • Neighbors
  • Grandparents, aunts and uncles
  • Support groups
  • School
• Your child should continue all of their normal activities, such as school and sports.
• Your child may be concerned about telling friends about their diabetes.

Should I change the way I discipline my child?

• Rules and discipline should not change.
• Continue to use appropriate rewards and consequences as you did before diagnosis.
• Set clear expectations for what your child will do for diabetes care.
• Diabetes care must become a part of your child’s daily routine.

How do blood sugars affect my child’s behavior?

• Low blood sugars can make your child feel cranky and irritable.
• If your child is not behaving, test their blood sugar.
  • If blood sugar is in target range, discipline as usual.
  • If blood sugar is low, treat it.
  • When the blood sugar is back in target range, discuss the behavior.

Will diabetes affect my child’s school performance?

• Your child’s overall school performance should not be affected.
• You and your child’s teachers should not change your expectations.
• Your child can continue in all after-school activities and sports.
• Set up a Diabetes Plan of Care or 504 Plan of Care to ensure your child’s diabetes needs are met at school. Your diabetes social worker will provide more details.

What should I do if my spouse/partner and I disagree about dealing with our child’s behavior?

• All adults in the family should handle diabetes-related behaviors the same way.
• Try not to disagree in front of your child. Discuss your disagreements in private.
• If you are unable to agree on how to handle your child, seek professional help.

How will my other children feel?

They may feel:

• Forgotten
• Resentful
• Scared
• Angry
• Jealous
• Worried

These feelings are normal. Siblings often worry about the child with diabetes. Siblings may be jealous of all the attention the child with diabetes is getting.

Siblings may be scared that they will “catch” diabetes. They can’t catch diabetes, but they have some risk of developing the disease. The siblings of children with diabetes have a 1 in 20 chance of being diagnosed with diabetes at some point in their life.

What can I do to help my other children during this time?

You can:

• Bring them to the Hospital to visit.
• Explain what diabetes is and that they can’t “catch” it.
• Reassure them that you will work together to care for your child with diabetes.
• Spend some time alone with the sibling after discharge.
• If siblings are old enough:
  • Teach them the signs of a low blood sugar.
  • Instruct them when to call an adult for help.
• Involve siblings in the diabetes care if the child and sibling agree to this plan.
• It is always your responsibility to make sure that the diabetes is managed.

Can stress affect diabetes?

Stress can:

• Raise the blood sugar if your child is upset or sick.
• Cause your child to forget to check their blood sugar or take their insulin.

What about diabetes and depression?

• Children with diabetes are at increased risk of depression.
• These are signs and symptoms of depression (seen over a period of weeks):
  • Change in sleep (sleeping all the time, not sleeping)
  • Change in appetite (increase or loss)
  • Poor concentration (drop in grades at school)
  • Often in a “bad mood” or easily frustrated
  • Feeling overwhelmed
  • Feeling guilty
  • Not wanting to do things they used to like, such as sports or hanging out with friends

When should I seek professional help?

If you or your child:

• Feels like giving up
• Feels overwhelmed
• Experiences changes in mood
• Experiences a drop in school/work performance
• Is abusing alcohol or drugs
• Is being dishonest about diabetes care (not telling the truth about things like food, insulin injections, blood sugar results)
• If you and your spouse/partner cannot agree on the diabetes care at home

Where should I get professional help?

• Talk to the diabetes social worker.
• Talk with your primary care doctor.
• Contact your insurance company to get the name of a therapist who can work with you, your child or your family.

Your child’s emotional health is as important as his physical health. A positive attitude toward diabetes will help your child manage their diabetes well. How can I help my child emotionally when dealing with diabetes?

Listen

• Encourage your child to talk about their diabetes.
• Let them know it is OK to feel angry and upset.
• Ask if there is anything you can do to help.
• Sometimes all they needs is for you to listen.

Stay cool about blood sugars

• Blood sugars are simply bits of data. They tell us when your child needs more insulin or more food, or less insulin or less food.
• Your child may want to please you by reporting only “good” blood sugars. Your child may be afraid he will get in trouble for “bad” blood sugars. Some children “make up” blood sugars to keep out of trouble.
• You may feel anxious when the numbers are out of range. Understand that there will be times when blood sugars are high. When this happens, do what needs to be done to bring down the blood sugar. Do this in a calm manner. Take the emotion out of the diabetes care. The less emotional you are about blood sugars, the better off everyone will be.

Stay positive!

• There are MANY tasks to caring for diabetes on a daily basis.
• It is easy to focus on a missed blood sugar test, while not seeing that two or three other blood sugars were done.
• Praise your child whenever they “fly right.” Don’t just notice when they forget to do something for their diabetes care.
• You can say something like:
  • “Thanks for correcting that high blood sugar without being told.”
  • “I notice all week long you’ve been testing at meals. It's helpful to know you are taking this seriously.”

An education or support group can provide information and comfort to parents and children with diabetes.

• Support groups help you feel less alone.
• You will learn how other families cope and manage.
• Some information discussed at a support group may be different from what your Diabetes Team has told you. Please discuss any concerns with your diabetes nurse.

Pennsylvania

CHOP Diabetes Parent Support Network

Network of parents of children/teens with type 1 diabetes: Meets bimonthly at CHOP. Offers positive support, interaction and education for parents, caregivers, and children and teens with type 1 diabetes. View upcoming events.

CHOP Patient Education Program

Offers diabetes education or a review to you and your child/teen. Call 267-426-0271 to schedule, after you have discussed which class to take with your nurse practitioner. 

REACH

Rapport, Empowerment, Advocacy, through Connections and Health (REACH) is a CHOP program for teens and young adults ages 12-24 with special healthcare needs (including diabetes) and their families. Call: 267-426-0681 or REACH hotline: 267-426-5569.

Juvenile Diabetes Research Foundation

Philadelphia Branch
225 City Line Avenue, Suite 104
Bala Cynwyd, PA 19004
610-664-9255
www.jdrf.org/easternpa

American Diabetes Association

150 Monument Road, Suite 100
Bala Cynwyd, PA, 19004
610-828-5003
www.diabetes.org

New Jersey

CHOP Diabetes Parent Support Network

Network of parents of children with type 1 diabetes: Meets bimonthly at CHOP. Offers positive support, interaction and education for parents, caregivers, and children and teens with type 1 diabetes. View upcoming events.

FACT (Families Affecting by Celiac and Type 1)

This group is for parents of children with both celiac and type 1 diabetes. Parents meet bimonthly to share information on cooking, eating out, carb counting, shopping for gluten-free products, and raising awareness about celiac and living with two chronic conditions. Families can take part in activities throughout the year. Call: 856-354-8642.

Juvenile Diabetes Research Foundation (JDRF)

JDRF South Jersey Chapter
1415 Route 70 East, Suite 311
Cherry Hill, NJ 08034
856-429-1101

JDRF Mid-Jersey Chapter
28 Kennedy Boulevard, Suite 180
East Brunswick, NJ 08816
732-296-7171

JDRF Central Jersey Chapter
740 Broad Street, Suite 4
Shrewsbury, NJ 07702
732-219-6654

Learn more about JDRF.