Teens and T1D!  

I remember that before my son hit his teens, I swore that our lives wouldn't be as hard as what I was hearing from parents in the trenches. I was so sure that we were going to do better than all those other parents. And now I can humbly say that there is no easy path forward with teen kids: There are so many challenges as our kids grow up and transition to being independent with diabetes management.

On today's podcast episode, we get one flavor of what it’s like when you’re in the teen trenches. Rob comes onto the show to think through what to do about ongoing conflict he and his wife are having with their almost-17-year-old T1D daughter. 

All the conflict centers on a new pump that they changed to a few months ago. The settings they are using for the new pump aren’t working — but their daughter is digging in her heels, insisting that she’s going to continue to do it her way. And her way means lots of LOW lows, massive number of juice boxes (Rob is buying them in bulk at Costco) and many-too-many sleepless nights for mom and dad. Basically, this teen has staked her turf, insisting that she be independent around the settings on this pump, even as it’s causing frustration and danger. 

There was some good news, though: Rob noted that at their last endo appointment, he heard his daughter repeating back to the doctor all the things that he had articulated to her about the reasons the pump didn’t work. She clearly just can’t talk to him about it yet, but she is integrating it. Bottom line is that sometimes with our teens, we have to lean into the village. One suggestion? Have more endo appointments. Let the endo direct this conversation with his daughter. After all, if our kids won’t listen to us, it’s important to find a proxy who we trust — and who they are wiling to listen to. 

We also looked at the way that this diabetes management issue is hijacking the relationship Rob and his wife have with their daughter. At this point, any time they try to talk to her about it, they end up in an explosive argument. I made a few key suggestions of how he can approach her so they can find a way to discuss it without a fight. 

Hope you come away with some additional tools to apply to the hard moments you have with your T1D kiddo, either now or when they finally it those rocky teen years.

Enjoy the show!

One dilemma I’ve heard from parents again and again: If my T1D kid is acting out because of a high blood sugar, how do I parent that? Do I give my kid a pass because I know that their high affects their mood? Or do I parent the behavior as though diabetes isn’t operating in the background? In this week's episode, Julie comes on the show to talk about how this issue is playing out for her 6 year old son, Ethan, when he’s at school. 

It sounds like Ethan has an amazing teacher: She’s paying attention to his diabetes and wondering if his high blood sugar might correlate to some disrespectful behaviors that she’s seen. The problem is that Julie and her husband haven’t seen that same correlation at home: Although they know that their son is very wiggly, has a lot of energy, and likely has a hard time sitting still — especially in the afternoons at school — they haven’t seen disrespectfulness when his blood sugar is out of range. At the same time, when he’s high — or has a big case of the wiggles — Julie will take him for a run to help him get his energy out or bring his blood sugar down, something teachers can’t do for him at school. Whether diabetes is driving Ethan’s behavior or not, we came to the conclusion that the teachers might be overly focused on Ethan’s diabetes, giving a reason for his not-so-stellar behavior when it would be better to just treat it as a behavioral issue.

Truth be told, we really never can know how our kid’s blood sugars are affecting them. But in my experience working with T1D adults, I found that they often felt frustrated with their parents for attributing their behavior to highs when they were kids. And the reality is that we all need to strive to be our best selves, even under less than ideal circumstances. So in the show, we talk about different ways we can help our kids show up as their best, whether it’s the high blood sugar getting in their way, or just the wiggles.

Hope you enjoy the show! 

I often say that diabetes sits on the fault lines in our lives: If you're struggling with your relationship to food, diabetes makes it trickier to figure out how to eat.  If you’re challenged in asking for what you need from friends, diabetes adds extra pressure.  If you’re finding yourself in conflict with your spouse, diabetes sits right there. 

In this week’s episode, Jessica comes on to the show to talk about the worries she has about where diabetes is sitting for her 7-year old: Grace is struggling to make connections with peers, but Jessica isn’t sure how much diabetes is playing a role. 

Bottom line: Grace doesn’t like it when classmates ask about her devices.  And she’s in good company there — many kids are uncomfortable about that. At the same time, I pointed out to Jessica that Grace’s classmates don’t seem to be mean, just curious.  Together we thought about ways that Jessica could explore with Grace about what, exactly, makes her uncomfortable, as well as playing with different ways she could respond.  

At the same time, I leaned into validation, knowing that that could be so powerful for Grace.  Jessica said that “if I were in second grade and had diabetes, I would probably feel that way too” — and I reflected on how great it could be for Grace to hear that from her.   

Certainly, we did problem solving, from Jessica organizing playdates to talking to the classroom teaching to thinking about the value of a social skills group for little Grace.  But mostly we sat with how hard it is for a kid to have type 1.  We sat with that uniquely parental fantasy we have that T1D is struggle enough and that our kids should have nothing else to deal with.  At the end of the day, this is what caring parents like Jessica wish for their kids.  

Hope you enjoy the show!

We all know that transitions can be hard for kids — and adding diabetes to the mix often makes them even trickier. On today’s episode I spoke about this with Kaylor Glassman, the founder of Diabetes Support Partners and a fellow diabetes coach whose opinion I really trust. Together, we thought about what’s going on for the 5 year old son of a listener who seems to be struggling with some separation anxiety. But the issue is confused because instead of it being a straightforward nervousness about mom leaving, he’s saying that he’s worried about whether new adults are going to be able to take good enough care of his diabetes. 

Kaylor started with such a good point: She noticed that mom is taking the very brave step of leaving her son with new adults in the first place, something that’s often hard for us T1D parents. And this kiddo is making it trickier, since he’s questioning whether he is T1D safe with these new adults. The tricky thing, of course, is that talking about diabetes in this way might just be a way for a child to express general nervousness. After all, they know that they will have our attention if the conversation is about T1D. But ultimately, I believe the antidote to this new anxiety is to continue to reassure this kid that he is safe. After all, this is what we want for our kids (and for ourselves!): a safety net of trusted adults that they can rely on besides mom and dad. 

So what to do to help? First of all, stay the course. This mom should keep practicing leaving her son with safe adults and continue to communicate her confidence that he will be fine. Kaylor and I talk about how important it is to think about your tone as a parent, letting your child know what’s going to happen, and being attentive to their potential worry, but also leaning into the idea that everything will be alright so we don’t allow anxiety to grow. We talked through other great strategies to manage a child’s anxiety and to help them see and understand that their worries aren’t always a good predictor of what’s actually going to happen. Finally, we thought about how our own anxiety might actually be in the mix. Yes, this mom is doing an amazing and brave thing in dropping her T1D kid off with new people, but often we adults have to talk through and process these new steps for ourselves and our little ones pick up on our energy. As hard as it can be, we have to try to protect our kids from our own worries. 

Listen to hear more about:

*Timing a conversation with your child about a new experience so they have less time to worry

*Why it might be important to circle back to talk to a child after they’ve done something that makes them nervous

*How to strike a balance between validating our kid’s experience and keeping their anxiety small

*Ways we can protect kids from our own anxiety

Hope you enjoy the show!

There are those shiny kids who know how to do diabetes and have been doing it for years, the kids who feel like diabetes actually makes them special.  But even these kids have rough patches when they don’t want to do the job anymore, when they feel like they don’t want to really be “out” with their diabetes.

That’s what I’m talking about this week with Megan.  Megan’s son Henry — now 15, diagnosed at 7 and the oldest of four boys — has had a big shift in his diabetes behaviors.  Up till now, he’s been really independent with management and Megan has only had to step in to help occasionally or during the night.  But she’s noticing changes. Examples: She often can’t read his numbers when he’s at hockey practice — and when she can, he’s sometimes playing low without treating.  He’s sometimes walking out of the door with just some skittles in his pocket — no backup supplies in sight.  He’s minimizing when she asks about it, saying that he’s “got it.”  

Megan wants to do what any mother of a T1D kid wants to do — get him back on track.  And she’s very supportive when she talks to him, wondering how she can help.  We talk about adding some additional tools to her parenting arsenal:  First we look at getting more curious about his experience, understanding better where the shift is coming from and what’s making it hard for him to manage more effectively.  Megan knows and suspects that some of this comes from shifts he’s experiencing in his hockey cohort in particular, but also knows that he’s struggling in general.  After we talk about her getting curious, we look at the tool of validating, noting that it is so hard for him and so understandable that he’s struggling.  Meeting him in this place is a powerful way for him to feel better understood and heard.  Ultimately, it’s a way to keep communicating her care and concern, without creating conflict around diabetes.  

We also looked at parenting choices she might make: She might create some containment around diabetes management by involving her son’s coach, but I note that getting that kind of outside intervention with a teenager has a lot to do with the needs and sense of independence of the kid: If a child will feel like they are being well supported when a parent makes that move, it’s a perfect choice.  But sometimes our teens need to try to course correct on their own.  As parents, it’s a delicate balance to figure it out.  

Enjoy the show!   

The oh-so-frequently forgotten siblings of our T1D kids!  In this week’s podcast episode, a concerned mom and dad come on together to think through what’s been happening with their 6-year old, in the aftermath of their 3 year-old’s relatively recent diagnosis.  

The picture here is a bit complicated:  At first, this older brother was accepting and helpful, in the same way that older siblings often are when a new baby arrives in the house.  But as time went on — and the older brother recognized that diabetes was in the house to stay — his behavior shifted. He now avoids items touched by his younger sibling, expresses some fears of contamination and is pretty rejecting of his younger brother.

What’s a parent to do?  We take a pretty deep dive, trying to untangle all the possibilities of what this 6 year-old’s behavior means, what he’s trying to express, and how to effectively address it.  

First and foremost, I talk with these parents about validating their son’s experience.  After all, when diabetes comes to a family, siblings are often sidelined.  Acknowledging that to a kid can be really calming for them, allowing them to feel seen and understood, even when they aren’t getting the attention that they used to get — and that they still deserve.  Mom shares a moment when she did a beautiful job validating their son’s experience  — and got such a strongly positive response from her boy.  I encourage them to do this more, more, more, reminding them that their son’s feelings have been building for a while and will take a while to unravel.  

We explore other possibilities as well: one-on-one time with this older sib; setting clear limits on inappropriate behaviors, with clear consequences; and finding good books that talk about the ways that little siblings can be hard to adjust to for their older brothers and sisters.  And while I talked to them about the ways that some of this sibling conflict might be completely normal, I also encouraged these parents to keep a close eye: This older brother has such a strong concept of his younger brother being “contaminated,” that if that continues over time, I think they should consult with their pediatrician to see if they should have their son assessed for OCD.  While so many of these kinds of behaviors are normal as our kids grow and change — especially in the face of a trauma like a type 1 diagnosis —  I don’t want this family to let a problem fester, if they ultimately need more support for their son.

Hope you enjoy the show!

If you’re looking at the data on diabetes management based on age, you see a big camel’s hump in the graph when you get to the teen and early 20s. At these ages, kids just don’t do as well with managing their T1D — and it shows in a1C outcomes.  The average a1C in this age range pops up to the mid 8s.  But even though that may be normal, it certainly doesn’t mean that we parents feel comfortable with it.  

Cue my conversation for this week’s episode with Jo, mom of a 14-year old who was diagnosed about a year ago.  After talking about the oh-so-familiar challenges that Jo and her son have struggled with in this first year since diagnosis, we started unpacking how her son’s lack of lunchtime dosing isn’t just “reckless.”  In reality, it makes a lot of sense. 

For this 14-year old, as for many of our kids, giving insulin is more about the social discomfort and emotional weight that comes with managing a chronic illness in front of peers.  Consider it this way: at 14, fitting in and feeling normal is almost everything. Giving that shot — and maybe even punching numbers into that pump — can feel like a glaring spotlight on differences. Thinking about it like this allowed Jo to see her son’s behavior not as reckless, but as a very human response to the pressures of teenage life with diabetes. 

With that as a backdrop, I encouraged Jo to shift her focus from frustration to acknowledgment of her son’s successes. Despite the struggles, he’s managing a lot more than she sometimes gives him credit for — bottom line is that he’s dosing whenever he’s not with friends, a big win.  I also invited Jo to explore this issue with her son through open and non-judgmental conversations. Ultimately, while we should never unbuckle the “diabetes seatbelt” and it’s important to try to keep numbers in range, it’s equally important to create a safe space for our kids to express their feelings and to find ways to manage diabetes that align with their need for normalcy and independence.

Hope you enjoy the show!

I loved the conversation I had for today’s podcast episode. It touched on a topic that no one has ever asked me about, even though I know it affects many of us: the difficult balance of managing work responsibilities while caring for a child diagnosed with Type 1 diabetes.

I’m talking with Nikki, a mother from the UK whose 6-year old daughter was diagnosed with T1D about a year a half ago.  As Nikki learned more and more about diabetes after her daughter’s diagnosis, she started to recognize that she needed to make significant adjustments to her work life in order to truly meet her daughter’s needs. The lack of support and understanding from her employers compounded her feelings of guilt, overwhelm, and depression. Ultimately, Nikki made the tough decision to step back from her job, allowing her to provide the dedicated care her daughter required.

Nikki’s work/life balance ultimately has a happy ending—she started her own business where she works less and earns more. But it prompted her to think about the kinds of support that T1D parents need: Her journey heightened her awareness of the precarious nature of balancing professional obligations with the demands of caregiving.

In many ways, Nikki’s story is not unique; many parents face similar struggles as they take on the often crushing burden of managing their child’s T1D — and many parents adjust their work schedules to accommodate these needs. But it’s a lonely and hard decision, so I was grateful to Nikki for coming forward to explicitly name how challenging it can be.  We have a brief, but wide-ranging conversation.  

Listen to hear more about

*My thoughts about how some of the work/life balance parents need help with is actually a political issue

*Some clear ideas about mourning and challenges parents face when their child is first diagnosed.

*Starting to create some community around T1D

Hope you enjoy the show!

In this week’s episode, I have a conversation with Mary, mother of a newly diagnosed little boy: Campbell was diagnosed about 6 months ago at two and a half.  

Mary and her husband are getting the hang of diabetes but it’s been such a big learning curve that they’re thinking of postponing sending Campbell to preschool in the fall: Mary just can’t picture how a school transition would go.  The thought of entrusting her son’s care to someone else is understandably daunting. As we talk, we realize together that Mary’s also hesitant to send Campbell because she’s not sure how to ask the school for the help that her family needs to manage type 1.  Ultimately, she doesn’t want to burden others with the complexities of managing his diabetes and learning the ins-and-outs of the disease. 

Together, we delve into her worries and explore the emotional landscape of becoming a T1D advocate for our kids. We discuss the vital importance of self-advocacy, not just to ensure that our kids receive the best possible care and support, but also because it’s critical for us to model for them how they can ask for the help they need — today and in their future. We also look at how this kind of advocacy helps create a safety net for our kids. 

I share several strategies to help Mary feel more comfortable both advocating and leaving her son at preschool: We talk about the small steps she can take to practice, mostly by starting to advocate with family members, creating a step-by-step map for starting to leave Campbell with those people who already love him. We also look at ways to think about advocating at the school by her first getting super clear about what kind of support she wants Campbell to have.  

Listen to hear more about:

• the reasons you might consider transitioning to a pump, even when shots are working
• the mistakes school care providers might make in management — and how to think about that
• an upcoming workshop that will help you build a better relationship with your child’s care team at school

In today’s episode, I talk with Tiffany, a mother whose 9-year-old daughter was diagnosed with type 1 diabetes only a few months ago. Tiffany opened with her primary concern: the limitations her daughter might face in the future. Even though she couldn’t picture exactly what those limitations would be she fears diabetes will hold her daughter back. 

Tiffany’s worries are a mirror of what so many T1D parents feel—we worry about the hurdles our kids are going to face. It’s easy to get caught up in the “what ifs” and overlook the “right nows.” So I brought Tiffany into the present, looking at the ways her daughter might have felt limited since her diagnosis and how Tiffany can respond to that. 

Validation became the keyword of the discussion. I emphasized the importance of acknowledging the frustrations and limitations her daughter is currently facing — in the example Tiffany gave, it was about sitting out from PE, something we’re all familiar with.  I work through a powerful validation tool with Tiffany that she’ll be able to use again and again as she parents diabetes, one that will keep her closer to her daughter’s experience, with the hope that that will help her daughter make a smoother adjustment to a life with type 1. It’s not foolproof, but it’s a way for our kids to understand that we’re alongside them.  

Listen to hear more about:

• The nitty gritty of how to construct a strong validation of our kid’s experience
• Thoughts on how to stay close to our kids as they grow their diabetes responsibilities so we’re attuned to what they actually can manage.
• A discussion on the thin line between fostering independence and the risk of “diabetes burnout.”
• How powerful it is for a parent to be together with their child on their diabetes journey

 Hope you enjoy!