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Coming of Age with Diabetes

Feb 6, 2007

This week we are happy to bring you a special feature by Laura Plunkett., BA Psychology. Her book The Challenge of Childhood Diabetes recounts her strategies for raising a healthy child and addresses many of the fears and concerns parents often have. This week she discusses how to address your child’s concerns about severe hypoglycemia.

“Mom, what happens if I get so low that I faint?” my son Danny asked. We were in the car, on the way to a doctor’s appointment, and this question caught me by surprise.


Thinking quickly, I answered, “I would either squirt the frosting tube into your mouth or I would give you a shot of glucagon, then your blood sugar would go up and you would wake up,” I replied.
“Well, what happens if you’re not there?”
“Someone will call 9-1-1, and the EMTs will take care of you.”
“What if I’m all alone and no one’s there?”
“You’ll stay in a coma until someone finds you and calls 9-1-1.”
“What if no one finds me?”
“Then you might die, Danny.”
“Oh, bummer!”

At some point in the life of any child with insulin-dependent diabetes, the issue of extreme low blood sugars becomes something they think and, hopefully, talk about. In our case, Danny was eight and I was completely unprepared. As soon as I recognized where our conversation was headed, my mind started racing, my heart began pounding, and, although I tried to sound factual and unfazed, I was bordering on tears. Thankfully, he was in the backseat and couldn’t see my face.

After this talk, I finally mustered the courage to ask our endocrinologist the question I had been avoiding, “What does happen if my son goes low and nobody is there to help him?” The answer was different from the one I’d given Danny in the car, and I had to go back to him with my new answer.

“Hey, Dan, do you remember when we talked about low blood sugars and what might happen?”
“Well, I asked a doctor, and he said that in many cases your liver would release glycogen and you’d revive on your own.”
His response? “Cool! Let’s get lunch.”

Whether triggered by a playground comment, a diabetes story on the news, or the realization of the reason for the glucagon kit, the issues of coma and death eventually crystallize in a child’s mind. It is important for a parent to be prepared to answer questions, give information, and be reassuring. These are some thoughts I wish I’d had in mind when the questions started:

1. Try to be as comfortable and open as possible. Your child will tell you more about what questions and concerns he has if he feels you can handle his anxiety. He’s likely to back away if he feels he’s upsetting you.

2. Meet your child at her age level. A five-year-old who is always accompanied by an adult and asks, “Am I going to die?” needs a firm and reassuring “No.” A teenager, on the other hand, is looking for an in-depth discussion and needs the facts that will help her make good choices.

3. Somewhere in the conversation, ask what prompted the question. You will often be surprised at what you can learn when you ask questions instead of simply answering them.

4. Work toward easing anxiety. Comment on all the people who are watching out for your son or daughter. Review your safety policy including the location of glucose tabs, the schedule of frequent blood glucose tests, etc.

5. Brainstorm together ways your child can be safe in situations he is worried about.

6. If there are questions you can’t answer, encourage your child to talk with his nurse or doctor at your next appointment.

In my case, both of my early conversations with Danny felt incomplete, but, as in every parent/child exchange, this just gives us the opportunity to try again.

Laura Plunkett has a BA in Psychology with Honors from Brown University. She has been a head teacher in a preschool intervention program, a research assistant to Dr. Aaron Beck studying anxiety disorders and depression, and had a thriving therapeutic private practice for 14 years with families, individuals and couples. She is a workshop leader and public speaker who is comfortable with large audiences and often speaks together with her mother on issues of parenting. Her avocation during Danny’s illness has been doing research on the latest developments in diabetes and nutrition and corresponding with researchers and specialists in many countries. She is a member of the Juvenile Diabetes Research Foundation. You can reach her at lauramplunkett@challengeofdiabetes.com.