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Dear Dr. Arzinda,

dr-arzinda-fatimaI am a mother of type 1 diabetic child. My son was diagnosed diabetic when he was 4 years old. Now he is 5 years old. No one in our family had diabetes. It was a shock for the whole family. When the doctors told us there is nothing short of insulin injections for life, this news was like a bombshell for us. My son used to cry before and after each needle prick, it is very difficult to control sweets and candies. I feel depressed all the time, I weep secretly, I feel exhausted and tired all the time taking care of his meals, insulin dose and temper tantrums. I have 2 other kids also, it is very difficult for me to manage household tasks. I have no time for myself and my other children also feel neglected. Now my diabetic son is going to start school and I’m very apprehensive how we will manage his diabetes in school…….please reply in detail.

 Exhausted Mother.

 

Dear exhausted mother,

First of all I would like to tell you that you are a very brave mother as you have been managing your child’s diabetes effectively. And let me tell you that you are not alone, there are 1.3 million diabetic children worldwide whose mothers have all gone through the same ordeal as you have, and if they have come out of this dilemma then you can also do so with a little help. The initial phase of shock and denial followed by grief comes in the life of every type1 diabetic’s family. It is a natural response, but it should be over in days to weeks and should not linger on for months or years.

By now your child should be used to the routine of glucose checks and multiple insulin injections per day. Children learn a lot from their parents’ attitude. They can sense fear or stress in your actions. So first of all try to normalize your attitude and emotions. Act as if insulin injections are part of the normal routine just like brushing teeth or eating food. If you behave as if it’s an unusual thing the child will feel awkward and will react negatively. On the contrary if you take it easy your child will feel relaxed. You can make this opportunity to form a special bond between you and your diabetic child. Never weep in front of him. Give him confidence; gradually teach him about his insulin dose, filling the syringe, injecting the proper dose. He will feel elated that he can do something special that other kids in his family cannot do. Encourage him when he helps out in his own diabetes management. If you make him share this responsibility with you he will come out of grief reaction early.

You mentioned your other children as well who are not diabetic. You can also make them your assistants in helping around taking care of their brother with you. They can share the same healthy balanced food as this diet is good for everyone in the family. Plan healthy playtime activities or trips to the park or the movies where the whole family can enjoy together and the diabetic child is not singled out. Children can help you in small tasks like reminding you about keeping the insulin and syringes in your bag while going out somewhere, or reminding you the time of injection. By sharing responsibility they can take some burden off your shoulders.

One other person who can play a vital role is your husband. He should share some responsibility so that you can get some time off for your rest and relaxation. He can take the child out for a walk while you can catch up on some sleep. He can accompany your child on the routine doctor’s visits.

One other concern that you have mentioned is about your child starting school. It is an important milestone in every child’s life. He will go through an emotional stage of separation anxiety coupled with his diabetes care responsibility now being shared by the school staff. You must visit and discuss the whole scenario with the school administration beforehand. The school should be given clear written guidelines about the child’s medical needs. The school nurse and teacher will have to be taught about glucose check, insulin injection, signs of hypoglycemia and management of hypoglycemia. The child’s dietary restrictions, participation in sports etc should be discussed in detail. It is never a good idea to hide diabetes from the school staff as it can be hazardous in emergency situations. Most schools will understand the special needs and will be cooperative if you discuss at the time of admission. You can also read ‘’safe at school’’ section of our website www.diabetespakistan.com

Last but not the least I would like to emphasize the importance of peer group to you. It is highly advisable to join a diabetes education group for patients and their families. Such self help groups will be emotionally healing for both you and your child. Where he will meet other children like him and he will know that he is not alone, there are other children like him who are doing well. In the supervision of trained diabetes educators he will learn to take care of his diabetes independently. You will also learn from parents of other diabetic children when they share their experiences. It is often seen that diabetic children are more disciplined than their age fellows and generally excel more in studies and sports. You can join the diabetes group in diabetic’s institute of Pakistan.

I hope you have got the solution to your problem.

Regards,

Dr. Arzinda Fatima

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