This post is on healthcentral.com/diabetes. Written by Dr. Fran Cogan, head of Pediatric Endocrinology at Childrens National Medical Center in Washington DC.
It is May and our high school seniors have received those thin and fat envelopes determining their educational fate for the next academic year. Many will be living on their own for the very first time and have to become independent without the immediate support of parents. This task of "letting go" is a major developmental milestone for both the child and family members, especially parents (and even more typically - mothers). This transition is exceedingly tough and emotionally stressful. It is hard enough to send your child to a new environment away from the nest, but it is even harder to leave your child with diabetes in the midst of a bustling college dormitory! I certainly was no exception. After bidding farewell to my then 18-year-old son in the middle of the Arts Quad of Cornell University, I began sobbing and did not stop until arriving home 6 hours later. That first month was extremely difficult.
Now, add the additional layers of complexity in children and teens with diabetes, in which the family has played a major supportive role for many years. MAJOR STRESS!
1. Who ensures that your child is checking blood sugars at least four times/day?
2. Are they bolusing insulin for their carbs correctly?
3. Are they correcting blood sugars?
4. Do they have rapid acting carbohydrates available at all times?
5. What if they go low overnight?
6. Who is going to check their blood sugars at 3 am? (I know that parents will want to, and would if at all humanely possible! Maybe a remote blood glucose meter?)
7. Does that Resident Advisor know how to administer glucagon?
8. Who will check if my teen drinks alcohol and goes "low?"
9. What if they run out of insulin and forget to get refills?
10. Etc., Etc., Etc.
I am sure that parents could add at least 100 more concerns to this very short list. And, you do have merit in your anxieties about your young adult. So, how do the child, siblings, and parents emerge from this major transition without having severe emotional repercussions?
I have written past blogs about Developmental milestones in infants, toddlers, elementary schoolchildren, and adolescents. This particular developmental milestone (leaving the family environment) occurs as your adolescent becomes a young adult. How does one prepare for this disruption?
As with any change in family dynamics, it helps to be informed about "what to expect" in terms of child development. It is important to be prepared ahead of time so that reactions are not unexpected. Take advantage of your diabetes team to help prepare your young adult (and your family) for this major transition. As my students go through their senior year in high school, I begin to discuss different issues during each of my diabetes follow-up visits (with or without parent in the exam room):
1. The choice of the best college fit for their unique needs and personalities
2. Barriers that might occur as they move from home to college
**I am someone who has lived well past my teens, college years and now into my 40s.
To read more by Dr. Cogan, click here.