Partner’s Corner

Parenting a child with diabetes

There’s been a lot of talk on our Facebook page about how diabetes affects the whole family. Especially after this guest article about how Diabetes destroyed my relationship with my mother. Today, we have the other side of the story to tell – a mother’s story of parenting a child with diabetes.

type 1 diabetes

Before diabetes

 

The World Cup Soccer was upon us! The atmosphere was abuzz with all the excitement and schools were closing for holidays. My girls were gearing up for a slumber party to celebrate Kirsten’s 16th birthday, great excitement filled the house as friends arrived present laden and ready for a night of storytelling and fun after an evening at the fan walk.

I asked her not to sleep near two girls who had a cold as it was a long holiday and I didn’t want her to get sick. The party came and went and Kirsten got the dreaded cold. She left two days later to go and spend time in Elgin with a few close friends and when she arrived home with bronchitis was put on antibiotics. She was looking very pale and her loss of weight was almost shocking. The doctor seemed concerned at the time but said we could go away and to see him on our return.

Langebaan was like a breath of fresh air compared to the madness in Cape Town and we were looking forward to a couple of days rest with good friends. Kirsten crawled into bed and did not move. We spent days trying to get her to eat to no avail and then she started vomiting: something was wrong and we could all see it. The chemist said there was a bad virus going around and she stuck to fluids for a couple of days: Energade, Powerade and naartjies were her only input.

The scariest day of my life

 

I could see that there was something drastically wrong on the Sunday night – it was as if she was not registering my presence, her knees had swollen to the size of rugby balls, her movement was staggered and she looked like a skeleton with skin on. I could not sleep worrying about what was happening to my beautiful daughter, was it what I had feared the most?

The morning came and with it came the scariest day of my life. I went down to check on her and she was semi-comatose. We threw everything into the back of the car and got back to the doctor in Cape Town in record time with her passing in and out of consciousness. I ran into the doctor and I said what I had been dreading to say: “I think she has diabetes!” Tests were run and confirmation came through two hours later: Kirsten was a Type 1 diabetic, her HBA1C registered as her being one for at least 3 months prior to diagnosis and she was immediately started on insulin. A new chapter in our lives had begun.

Let me just add here that on my husband’s side of the family diabetes was prevalent and I had always had a fear that my children would one day be diagnosed. I had constantly had them checked throughout their childhood. I thought by now they were all safe from this terrible burden.

Days filled with diabetes

 

Our days were filled with diabetes: from doctors to specialists to diabetic educators and reps, it was like a neverending story and a huge overload of information. Could the doctors be wrong? What if it was the energy drinks and naartjies we had given her that had sent her sugars over the top? Could she wake up next week and be fine? “No” was the answer to all our questions and we had to resolve ourselves to the fact that all of our lives were forever going to revolve around diabetes.

Kirsten would have to inject herself three times a day at mealtimes and once before bedtime for the rest of her life. Our days of running into the shops turned into hours reading every label and checking the carb count. All temptations were banished from the house, no more fast foods, as we started our new journey.

Unfortunately for Kirsten, things just did not seem to want to come right. She had lost 11 kilograms and had no muscle on her at all, her BMI was only 16. She could only manage to grab a millimeter of skin to inject but her blood sugar levels were fantastic and her endocrinologist was very impressed with her management thereof. Despite her levels being fine, she kept getting recurring lameness in her legs (from walking the one moment to waking up lame the next), as well as severe neck pains and constant chest infections. We had to forbid anyone near her who was even remotely sick.

At the beginning of December we were thrown into shock as she woke up with a mass of glands on either side of her groin, she was scanned and the glands were in excess of 3cm each so it looked like a bunch of grapes. We anxiously waited as they ruled out lymphoma, but praise be to God, it was not so, and she was blasted with antibiotics to reduce the glands.

Complications of diabetes

 

Our annual holiday to Plett arrived and everyone was so eager and happy to get there, days filled with friends and relaxation and just time to forget about the negatives of the past six months. We enjoyed the first week without a hitch and then once again Kirsten fell ill: she could not eat anything which was most frustrating as diabetics have to eat, and we landed up in the hospital where they could not find anything wrong. Two days later she could not even drink without crying and when her breathing became difficult we once again packed up everything and raced back to the doctors who knew her history in Cape Town.

She can’t recall at all how she got back home, she had lost all the weight we had painfully tried to put onto her and she was admitted for an esophagogastroduodenoscopy showing she had picked up a viral infection which had left her with hundreds of ulcers from the mouth down into her stomach, another complication of diabetes. Once again, loads of meds and a struggle to get her to put on the weight which she desperately needed to gain her strength.

Friends were understanding and eager to learn how to deal with her should her levels drop and were a constant by her side throughout. My frustration was immense, I was so mad at the world, at my Creator, for allowing this to happen to my once super-healthy and fit daughter who had the world at her feet. How could this be happening and why could I not fix it?

child with diabetesMothering a child with diabetes

 

I battled every day to put on a smiling face so that she could not see my worry, I would spend hours sitting in her room at the dead of night praying and watching her just to make sure she did not slip into a coma, I had prayer circles going all over the world for my girl and yet no answers were coming. I realized that God had placed my son (who has Aspergers) in our care because he thought that we could deal with it. He had now obviously decided that we did that job well as Kirsten’s sickness had to be dealt with by us too.

I felt that somehow, somewhere, I had to find the inner strength to show Kirsten that she was still the beautiful daughter I always had, except now she was more special as now it meant that we would have to care for her daily, in all walks of her life. I prayed for the strength to guide me to help her in every way that I could: my shoulders are broad and would surely bear the load.

Not a day goes by that I don’t wonder what her levels are, what she is eating or how she is feeling, if she is not with me it takes everything in my being not to reach for the phone to check. The expense of the last years has been immense, but being her constant carer and companion throughout this ordeal has changed me for the better.

Diabetes brought us closer

 

We are aware of everything that we eat. This is usually the stage in a teenager’s life that they tend to drift away from the parents, but we have become more united. I still allow her freedom but help by providing pre-packed meals knowing that she can enjoy herself without having to worry about where her next meal is coming from. As a family, we have always been close but this disease has brought us closer. We are always on the lookout and we stand together and work through it so that she feels that she is never alone in this lifetime fight with diabetes. We take a small step each day learning and knowing more. Her smile is constant even through all her worries and ill health and this keeps us going.

My daily thoughts revolve around Kirsten and my prayer is for a cure for diabetes to help, not only my daughter, but the millions of people living with diabetes all over the world.

– Sue

PS: Kirsten is now a successful mountain climber and blogger – follow her adventures on Instagram: cape_town_adventurer

 

Life with a Type 1 diabetic husband

Ever wondered what it’s like to be on the other side of diabetes – the partner of someone with diabetes? Here at Sweet Life, we’ve always thought it’s such an important (and under-appreciated) part of living with diabetes. That’s why we have a whole series of Partner’s Corner articles: for the husbands and wives, the moms and dads, the friends and colleagues of people living with diabetes.

 
Victoria wrote to me last week with this glimpse of life with a Type 1 diabetic husband…
 

type 1 diabetic husband

 

We got married at a very young age, maybe because we felt we living on borrowed time. Everything you think marriage entails is amplified when everyday is a fight against a mountain of testing, insulin, highs and lows. Waking up in the middle of the night, placing your hand on him to make sure he is still breathing and okay. 2am and 4.30am testing sugars… Rushing to get something to eat to prevent that low.

 

Every doctor’s visit you hold your breath, getting the bad news that his kidneys are failing and his high blood pressure medicine is basically killing him. In and out of hospital trying these pill, trying those pills. Eating no meat for months to help the kidneys build back up.

 

Looking at this wonderful man that will argue with you to give the homeless man the bread he asked for while busy going into DKA, keeping him awake and alert while rushing him to hospital. What did he do to deserve this?

 

Worrying about him 24/7 and then even more. He loves so fully and laughs so loud. He lives despite everything this disease has thrown at him.

 

When you’re young, you dream of getting married, having kids and this amazing wonderful life, but sometimes God has another plan for you and things you wanted aren’t in the books. But I would for sure not trade anything.

 

He is my always and forever.

 

– Victoria

 

 

Diabetic tips for the whole family

“One of my children has diabetes, the other doesn’t. How do I make changes that the whole family can adopt so that my daughter doesn’t feel like she’s making our lives more difficult because of diabetes?” Fatima Richards.

Dear Fatima,

The emotions that parents deal with when a child is diagnosed with diabetes are the same as any serious medical condition. Confusion, shock, denial, sadness, anger, fear and guilt are some of these emotions.

Unfortunately, guilt is a feeling common to many family members, the patient as well as the parents. I believe that guilt is one of the most destructive negative emotions – it drains you so that you can’t focus on more important things.

Getting the whole family to deal with these feelings openly at the time of diagnosis helps with long term adjustment. As you all learn to live with diabetes, you will become more used to it and find ways to fit it into your life more naturally. Fitting diabetes care into as normal a life as possible is the major goal.

Remember, too, that if all family members have a positive attitude, life with diabetes will be much easier. One day at a time is a good option!

How to help the whole family adjust to diabetes:

  • Keep your family routine as close to the previous ‘normal’ as possible.
  • Whenever possible, fit diabetes care around your child’s lifestyle, rather than her life revolving around diabetes.
  • Remember, children with diabetes are children first. Their diabetes should not define who they are.
  • Explain any changes that are made because of diabetes to everyone in the family.
  • Remember that nobody is being punished because of the diabetes. Everyone is just going to follow a healthier lifestyle. And this is a good thing.

– Jeannie Berg, Diabetes Educator

Photo by Jose Ibarra on Unsplash

Dealing with diabetes complications

My husband is a diabetic, and I would like to know how long it takes before diabetes affects your liver? Should I be worrying about him?” Alicia Greenway.

Dear Alicia,

You’re wise to think about steps to protect your husband’s liver – diabetes is a lifelong condition that affects the liver and vice versa. Being informed is the first step towards ensuring good liver health. Those with diabetes are at higher risk of non-alcoholic fatty liver disease, a condition in which extra fat builds up in the liver even if you drink little or no alcohol. Other medical conditions related to diabetes — including obesity, high cholesterol and high blood pressure — also raise the risk of non-alcoholic fatty liver disease. Diabetes does not cause fatty liver disease, but the two tend to occur in the same people because the same conditions cause both problems.

Diabetic-related liver disease can be largely prevented. Good control of blood sugar, maintaining a healthy weight, and having regular check-ups to monitor the effects of medication can help reduce the risk of liver problems.

Strategies for protection against fatty liver disease include:

  • Working with your health care team towards good control of your blood sugar.
  • Losing weight if necessary, and trying to maintain a healthy weight.
  • Taking steps to reduce high blood pressure.
  • Keeping your cholesterol within recommended limits.
  • Not drinking too much alcohol.

Then, let’s talk about worry. “Worry never robs tomorrow of its sorrow, it only saps today of its joy.” Leo Buscaglia.

Having a partner with diabetes puts unique strains on a relationship, but it can also bring you closer together if you learn how to work together. Here are some golden rules for rising to the challenge of managing a chronic disease like diabetes:

  • Get educated
  • Communicate
  • Listen
  • Set shared goals
  • Make room for negative emotions
  • Get support from others
  • Commit to nurturing your relationship.

You can do it if you work together.

– Jeannie Berg, Diabetes Educator

 

How to help a poorly controlled diabetic

My dad is a poorly controlled Type 2 diabetic, and he doesn’t seem to care. I keep telling him how serious his condition is and that he has to take care of himself, but he continues eating whatever he likes and says he’s too old to change. What can I do?” Celeste Damen.

Dear Celeste,

It isn’t easy for people to hear that they have diabetes. Diabetes is a condition that cannot be cured: it has to be taken care of every day. People who have diabetes have to make some important changes in their lives, but if the change is forced on them, they may not want to do it.

This is what is probably happening with your dad. He most likely knows exactly how important it is to look after his diabetes, but might still be in denial or angry that this inconvenience has been brought into his life.

The fear you feel for your dad’s condition also projects to him, and he is probably trying to reassure you by giving you excuses that he is too old to change or that the situation is not that serious.

Instead of telling Dad what to do and being cross with him when he doesn’t do the right thing, you need to ask him what changes he is willing and able to make. Then encourage him to follow through on what the two of you have decided.

Diabetes has not only happened to him: it has happened to your whole family. This is something all of you have to accept. It’s a good idea to get the whole family to adopt healthy habits, so that there will be less temptation… Offer your dad help, but try not to be the Diabetes Police.

Good luck!

– Jeannie Berg, Diabetes Educator

 

Communication tips for hypoglycemic episodes

I’m looking for some tips or advice on how to communicate better with my diabetic wife. She has Type 1 diabetes and when she goes low it’s sometimes hard for me to know what to do, and hard for her to explain how she’s feeling. Also when she goes high, but low is more of a problem, because it can get dangerous. Any tips?” Luke Jacobs.

Dear Luke,

I think it’s really great that you are involved in helping your wife cope with her diabetes. The challenges faced by those who care about someone with diabetes are rarely discussed, and very real.

Diabetes is riddled with valleys and waves, otherwise known as lows and highs, and this can be totally frustrating – as well as scary – both for the diabetic and their spouse. Good diabetes management limits the frequency of lows and highs, but there is no guarantee. And there are so many factors that can influence blood sugar that there’s no such thing as a ‘perfect’ diabetic.

So what now?

First of all it’s important for you to be able to identify when your wife is going low. Sometimes, people who have had diabetes for a long time lose the ability to feel their lows – this is where you come in. Learn how to treat a low. Keep some glucose sweets or jelly beans with you so that you can help her if her blood sugar suddenly drops. Don’t be afraid to suggest she checks her blood sugar if you think she’s acting funny.

The trick is to be diplomatic about this. The last thing a wife with diabetes wants is pity – and what woman can be responsible for being snippy when her blood sugar is at 3mmol/L?

– Jeannie Berg, Diabetes Educator

 

How to support a friend with diabetes

“One of my best friends is a Type 1 diabetic and she often skips taking her insulin to keep her weight down… I know this is going to cause her long-term damage, but I don’t know how to convince her to look after herself better. Any advice?” Sune Terblanche.

Dear Sune,

One of my favourite quotes is by Seneca: “One of the most beautiful qualities of true friendship is to understand and to be understood.”  How lucky your friend is to have you. Teenagers are inclined to focus on one thing and not see the bigger picture. Your friend is most probably also feeling the peer pressure of other girls to be thin.

Teenagers are sometimes just tired of medicine as well. They get frustrated and even feel embarrassed by having diabetes and having to test and take shots and make excuses for not eating cake and drinking cooldrinks. At some stage they just decide to stop using insulin. Stopping insulin makes it easy to lose weight which seems like the ultimate solution.

Without insulin, the body cannot break down sugars from food to use as energy. So it breaks down fat already stored and flushes out the excess sugar through the urine. This leads to weight loss, but it also causes nerve damage, damaged eyesight, kidney damage and osteoporosis, amongst other things.

Being a good friend isn’t always easy, but taking the time to look after a lasting friendship is worth every ounce of effort. The big thing is to be honest. To be a good friend and get her trust, you have to be honest about your feelings and her actions. If you’re honest about how you feel, that will open up direct lines of communication with her and help her talk to you about skipping insulin and how you can help her stop doing this.

You owe it to your friend to start a conversation about it. Being honest is different from being so blunt that you’re hurting your friend. Try not to nag or police her, but use opportunities to point out to her what she is doing to herself. Reinforce the fact that you care about her and ask her how you can help. Remind her that she is brave enough to face the challenge that diabetes has brought into her life. Remind her that everyone is an individual.

– Jeannie Berg, Diabetes Educator

 

Support during a diabetic pregnancy

“I’m sure all husbands worry about their pregnant wives, but it’s extra worrying because my wife is diabetic and has to be in such strict control – or it could really harm our baby. I’m trying to be supportive, but sometimes it’s difficult… Especially because she’s so emotional!” Mark Roberts.

Dear Mark,

You have my sympathy!

Women who are pregnant can be on a real rollercoaster ride of emotions – highs and lows and everything in between. While some women seem to ‘bloom’ during pregnancy and are full of life, happiness and vitality, other women are tearful and apprehensive.

Pregnancy is a powerful experience: huge hormonal changes and a life-changing event are a lot to deal with. A woman who has diabetes has even more on her plate.

It is wonderful that you are supportive. Part of the support that you give should be helping your wife eat the right kind of diet, check her blood sugar regularly and do the right exercise.

The fear you have about the health of your baby is real, but this is also relevant for any pregnancy. Hopefully you have planned the pregnancy and worked out an action plan with your health care team. If your wife is keeping to her programme, the risk of anything going wrong is minimal. Contact her gynae or endocrinologist if you feel that something is not right: it is natural to worry, but one of the best solutions is not to nag her.

Mood swings tend to happen most frequently in the first 12 weeks of pregnancy. The mood swings usually decline between 3 to 6 months because the levels of the hormones become more constant. Here your wife will start to feel better and have more energy and hopefully be less emotional.

The emotions are difficult to cope with, I agree. It can be very helpful to allow yourself time out if the going gets tough! Remember that a pregnancy affects both partners: the golden rule is to talk about how you are feeling. You must voice your worries, concerns and anxieties. This goes a long way to relieving them.

Most importantly, don’t forget to take time for you and your wife to relax together and enjoy this wonderful, intimate and very exciting time.

Sometimes just being supportive and loving is the best thing you can do.

Enjoy your baby!

– Jeannie Berg, Diabetes Educator

 

10 ways to offer diabetic support


We all know how exhausting living with diabetes can be – here are 10 easy ways to offer support to your diabetic partner.

Being a supportive partner can be both a gratifying and a challenging role – especially when living with a person with diabetes. Diabetes affects the whole family, not just the one taking medicine.

Want to know how you can help?

1.      Try to keep food temptations away and have healthy options at home. Support the diabetic in your family by having everyone eat healthy. And don’t nag if they sometimes ‘cheat’ or stray from their eating plan.
2.      Make time to do exercise together – lots of fun exercises can be done as a family. Make exercising regularly a habit for both of you.
3.      Remind your partner to see their medical team on a regular basis. Help them set up a few questions to ask so they get as much as possible out of the visit.
4.      Set a reminder to have their monthly medication fetched from the pharmacy in time. Encourage them to test their blood sugar often.
5.      Educate yourself about diabetes. Learn as much as you can, from the right sources – Dr. Google is not always right!
6.      Learn to know the signs of hypoglycemia (low blood sugar) and what to do about it. Know how to test your partner’s blood glucose if necessary, and how to inject glucagon in an emergency.
7.      If sexual problems arise, talk about it. Counseling may help if one partner feels rejected, and there is medication for erectile dysfunction if it becomes a problem. Just ask!
8.      Look out for any signs of depression, mental fatigue or diabetes burn-out. Take action on these signs, as depression is not something that will heal itself.
9.      Respect your partner’s personal decisions. This is sometimes very difficult, but you need to show your faith in them – diabetes is, at the end of the day, their condition.
10.  Help your partner maintain balance in their life. Offer them a shoulder to lean on and help them to find solutions to their problems – but don’t try to solve the problems for them.
– Jeannie Berg, Diabetes Educator

How to fix bad eating habits

I feel like my husband thinks that if I don’t see him cheating on his diet, it doesn’t count. I don’t want to be a nag, but I know he isn’t eating right… How do you suggest I encourage him to eat better?” Cheryl Lee.

Dear Cheryl,

I have no magic advice for you, but I feel the pain of your situation. As a caring partner, you feel worried about how his eating habits are affecting his diabetes. From his side, he is obviously trying to please you by eating correctly in front of you (but cheating on the side).

You need to get your husband to take responsibility for his condition and accept the importance of eating correctly. After all: it is his health at stake here.

Perhaps you could help him figure out a meal plan that looks at his likes and dislikes, eating habits and schedule, and any other health issues that may affect the way he eats. Try and come up with a meal plan that’s realistic – and one he may actually stick to. That said, it’s always important to be sensitive when advising someone about their eating habits. Change is hard for everyone, especially older adults who’ve been doing what they do for a long time.

Communication is the only way that you are going to resolve this issue. Do it in a gentle way and if he does not hear what you are saying, be as honest as you can and tell him exactly how you feel.

Help him set small, achievable goals. Do this as a couple and focus on what is important. You know he doesn’t want you to be disappointed in him and your opinion is therefore important. This gives you the opportunity to help him. Maybe if you communicate to him how hard it is for you see him hiding his cheating, he might be more open with you and make everything a lot easier for both of you.

– Jeannie Berg, Diabetes Educator

Telling a new partner about diabetes

Hi. This may seem like a silly question, but I want to know how do you tell a new partner that you have diabetes? Or should I say nothing and see how things go between us (I’ve been dating this guy for 6 weeks).” Bongani Nobuhle

Dear Bongani,

It can be a real challenge to tell someone you have diabetes. Sometimes people who do not understand diabetes have bizarre ideas about the condition and may react in an unwanted or hurtful way. Of course, some people will be more open-minded than others.

It’s normal for people with diabetes to worry about what their date will make of their diabetes. So when is the right time to talk about it?

Telling a new partner about your diabetes will be influenced by your personal preference and also by your medication. It’s a good idea to let your partner know about your diabetes early on in your relationship if you are on insulin, or at risk for hypoglycaemia. It will make the first episode of going low or having to inject less of a surprise to him. It is also a good idea to explain your need to inject at a convenient time as some people may feel funny about needles. If you are on oral medication, you could wait longer and see how you go.

When you do decide to tell him, be your brave and bold self. I do believe he has a right to know. If it scares him away, then he wasn’t the one for you. If he doesn’t know what it is about, all your secret long trips to the bathroom to check your sugar and inject insulin might alarm him. What if you can’t get up to go somewhere private to check your blood sugar? You don’t want to sacrifice your health just to keep a secret.

When you do tell him, don’t be a drama queen: just state the facts. Give your partner a chance to take in the news and be patient. Everyone reacts differently and at different speeds. But remember: if he doesn’t support you or take your diabetes seriously, don’t waste your time or his.

– Jeannie Berg, Diabetes Educator

 

 

Diabetic tips for teachers

“This year I have a diabetic child in my class and I don’t really know what to do. I want to make him feel supported but I also don’t want to make a big fuss about the fact that he’s diabetic – he seems to be managing it very well… What do you suggest?” Linda Nkosi.

Dear Linda,

I think it’s great that you want to lend support to your learner who has diabetes. However, being in charge of children with diabetes can be a challenge unless you know about the condition – it’s a good start for you to get more information on diabetes.

Children with diabetes often feel isolated and alone. Having to test your blood sugar several times a day, keep tabs on what you eat, and give yourself insulin shots or other medicine is enough to make anyone feel self-conscious and different.

If he is willing to do an awareness project with you, it could be very helpful for the whole class. It’s very important to first talk this idea through with him and his parents, though – some people prefer to hide their diabetes and pretend that it doesn’t exist. If you tackle this project in an exciting way, the child will feel involved and the other children in his class will enjoy the topic and then, like children do, just move on to something else. Children are like that. They soon move on, but the message of hypos, testing and shots will be stored in their memory banks.

Remember that this child must always be treated like his classmates. Don’t make exceptions. Always remember, he is a child first. He has diabetes, but that doesn’t give him more or less rights than the child next to him.

Like everyone else, kids with diabetes get along better with a little help from their friends. What a lucky person he is to have a supportive teacher like you!

– Jeannie Berg, Diabetes Educator

 

Tips for parents of diabetic children

“My son is a Type 1 diabetic, but I don’t want to be overly protective and make him feel he can’t do anything. Do you have any tips for parents of diabetic children, and how to make life normal?’ Sam Shongwe.

Dear Sam,

The first thing you must realise is that a child with diabetes is still a child. He should not be treated differently than a child who does not have diabetes. Granted, you have more issues to cope with – like good food choices, insulin and testing – but these things shouldn’t stop him from having a normal, happy childhood.

The first thing to do is make sure he is safe at school. Let a responsible person know what his diabetes involves so that they can keep an eye on him. By doing this you won’t have to keep phoning him or the school to make sure he is okay: this will only embarrass him and make him withdraw from friends and fun.

Remember, he can also play sports and take part in physical activities just like any other child: you just need to plan – first talk with his doctor, and then help him with the routine of glucose testing, planned eating, and insulin. Work out a plan that he’s happy and comfortable with.

Encourage your child and allow him to socialise. Let him do parties, sports, sleepovers and camps if he wants to. Discuss a back-up plan with him when he does, but try to let him do his thing.

Most importantly, help your child to become more independent by getting him to take an active part in his diabetes care while he’s still young. Encourage him to solve problems and make choices with you about adjusting insulin doses, for example. Help him create a good lifestyle so that his diabetes doesn’t become too difficult to manage and hijack his life. Self-care is the key to developing any child’s independence and self-esteem: it’s important to get your child involved in self-care as soon as he is able to – with your supervision, of course.

Finally, recognise your limit of control. Accept that you cannot watch over him all the time, stand back and allow him more independence as he becomes more confident and responsible. It’s the same with any child: if they prove their responsibility, they get more independence.

– Jeannie Berg, Diabetes Educator

 

How to handle a diabetes emergency

“A friend at work is diabetic, and I’ve never really thought about it before because he seems to handle it really well. But last month he had a scary episode where he started shaking and we had to put sugar on his tongue. How can I help him to feel okay about it?” Sini Webster

Dear Sini,

The word “diabetes” can lead to (unnecessary) concerns in the workplace about productivity and reliability. Co-workers who don’t have much information about the condition often feel unsure how to treat colleagues who are testing blood sugar, taking medication and possibly having hypoglycaemic (low blood sugar) episodes during work time.

The person with diabetes may feel insecure, embarrassed and afraid of being seen as different: it can be difficult to know how to support or assist them.

The most important thing is to develop trust so that the person with diabetes knows that they will not be made fun of or penalised for having diabetes. Everyone involved needs accurate information about diabetes and how to manage it: good communication and co-operation lead to a healthier, more productive workplace.

The shaking was probably caused by an episode of low blood sugar. Other symptoms include sweating, heart palpitations, anxiety and – if the blood sugar is very low – disorientation.

It is important for those with diabetes to choose a few colleagues who know how to quietly assist and not panic:

  1. Encourage the person with diabetes to have either a few sweets, 2 to 4 teaspoons of sugar in a little water or half a glass of Coke or juice. If they are unable to swallow, place the sugar or some jam on their tongue.
  2. Once their blood sugar has been raised by the sugary food, they should have something healthy to eat to stabilise it: a piece of fruit or a slice of health bread and peanut butter.
  3. If possible, they should test their blood sugar at this point.
  4. If they are disorientated or unconscious, call an ambulance: it’s always better to be safe than sorry.

– Jeannie Berg, Diabetes Educator

Teenagers and diabetes

“My teenage son doesn’t want to take his insulin. He rebels against it as if it’s something only I want him to do, not something he needs to do to keep him alive. What can I do?” Jesca Ncube.

Dear Jesca,

Even the brightest, smartest and most driven of teens have a hard time dealing with the day-to-day demands of diabetes. Having diabetes is often the one thing that trips them up.

They feel that their freedom is compromised. They are stuck in a zone where they are constantly asked about their blood sugar and as a result some lie about testing and taking shots: they suddenly experience a sort of “freedom” by lying and getting away with it. A wake-up call is usually when they land up in hospital. Most diabetics are prepared to try and do something to prevent that from happening again.

Because we live in a fast moving world, today’s teens have little time for themselves. Many teens are stressed, tired, and often have difficulty keeping up with the things they want to do, never mind the things they don’t want to do. Teens are risk-takers and struggling for independence – within this struggle, taking care of their diabetes is definitely not a priority.

So to answer your question:

The most important thing is to stay involved.

  • Try and coach your teen into some kind of “contract” between the two of you regarding his insulin. Encourage him and make him accountable. Ask him what is helpful for you to do and what is not. Listen carefully.
  • Find a health-care provider he likes and let him be educated about diabetes and the optimal treatment. Get him to meet up with other teens who are also living with diabetes.
  • If the shots are bothering him, find out why exactly and see if you can change things to make a difference.
  • Find out if he could be a good candidate for an insulin pump. Teens love technology and they usually do very well with pumps because they are growing up in a world exploding with new technology.
  • Never be afraid to seek counseling. A teen might refuse to look after himself because he is depressed.
  • This is the difficult part: you as a parent know the importance of insulin in your teen’s life. Try to explain it to him and ask him to work with you. Baby steps.

The good news is that most teens who have periods of giving up on their diabetes care eventually mature and start to do better again. Be your teen’s best friend: best friends do not judge and always stand by you.

– Jeannie Berg, Diabetes Educator

 

 

 

Dealing with diabetes burnout

“I’m worried that my wife is suffering from diabetes burnout. She seems exhausted by her condition and uninterested in getting it back under control. What can I do?” Simon Smith

Dear Simon,

Dealing with diabetes burnout is complex. There is no “one solution fits all” because the experience isn’t the same for everyone. Each person lives with diabetes in their own way, and needs different kinds of support. Burnout is often accompanied by stress, anxiety, depression and a host of emotional states like anger, resentment, shame and guilt.

A few ideas to help your wife work around her burnout are:

  • Allow her to feel “burned out”. If she tries to hide that emotion, it just makes it worse. Denial is not good for healing. Help her think of positive things about her diabetes. For example: “At least I am eating healthy.”
  • Nurture her. Spend quality time with her. Teach her to nurture herself.
  • Get her to slow down some things in her life. The idea is for her to have more breathing space in her life so that everything isn’t related to diabetes.
  • Sometimes it also helps if she changes her diabetes management. If she is using a pump, maybe she could go onto normal injections for a while. Or if she is injecting and this is getting her down, she could follow up the idea of using an insulin pump. Maybe wearing a continuous blood glucose monitor might help take the stress out of all the fingerpricks for a while.
  • Encourage her to connect with other people with diabetes so that she knows she isn’t alone.
  • Help her realise that she must not strive for perfection, and accept that fluctuations happen, even when she is trying her best.
  • Instead, focus on her victories: what she is doing right, even the small things. Then, set some achievable goals that build on those successes.
  • Together, try to identify the barriers she has in managing her diabetes. This will help both of you to decide what she needs to change to have better control over both her diabetes and getting rid of her burnout.

Always remember that your diabetes team is there to help you. Remind her that it is never about how you fall, but about how you get up.

– Jeannie Berg, Diabetes Educator

Helping a friend through a diabetes diagnosis

“My friend was just diagnosed with Type 2 diabetes and weirdly the thing that’s bothering him most is what people will think. He doesn’t want to tell anyone because he says they’ll blame him for becoming diabetic – because he didn’t eat healthy or exercise enough. How can I help?” Shan Moyo

Dear Shan,

First of all, I think your friend is lucky to have someone like who cares enough for him to help him work through the barriers of accepting his diabetes. Because of all the studies that have shown that diet and lifestyle have an influence on Type 2 diabetes, uninformed people forget that there are numerous other reasons for developing diabetes as well. And the Type 1 and Type 2 labels also make people more judgemental.

To some people, their personal health problems and issues are exactly that: personal. Frankly, your friend doesn’t have to share with everybody that he has diabetes, but it is a good idea to let someone close to him know, in case of an emergency. One of the hardest things that newly diagnosed people with diabetes experience and fear is that those who have known you for years start treating you like you’re different. They see your diabetes and not you. But help him look at it this way: no one today would accuse someone with AIDS of giving themselves the condition. So why allow anyone to do it with diabetes?

What can you do? Be an active reader and read your friend like an open book. Listen more and talk less. Help him come to terms with his diabetes and find confidence in managing it. Don’t let him assume that others are judging him: nobody has any power over what other people prefer to think.

Finally, if your friend is really struggling with a lot of mixed emotions, remind him that it’s perfectly normal to feel that way, and that it’s okay to need some help with the burden of managing a demanding condition. And lastly, one of my favourite quotes by Lao Tzu for him: “Care about what other people think and you will always be their prisoner.”

Help him to live free and happy.

– Jeannie Berg, Diabetes Educator

 

How to deal with a diabetes diagnosis

“My son has just been diagnosed with Type 1 diabetes and we all feel like our world has been turned upside down. But he’s really struggling to talk to us (and his extended family) about his diagnosis. Any tips on how to begin?” Razan Naransamy

Dear Razan,

When a child is diagnosed with diabetes, both parent and child feel different emotions. In the beginning, parents are inclined to spend time worrying about the physical effects and the day to day management of a condition they don’t yet know anything about. The child goes through different feelings, like sadness and hopelessness, even anger and frustration.

It might help to find someone your son will confide in – even if it’s just to find out why he doesn’t want to talk about his diagnosis. It could be a diabetes nurse he trusts or a psychologist or even a family member or friend. Don’t feel bad about getting help. There are many reasons he might not want to share: he might feel isolated, depressed, afraid or even angry at you. Because you are the one in charge of the tests and shots and the policeman of what he eats or does, it might be easier to blame you. He could even be feeling embarrassed because of the sudden overload of attention.

Helping your child involves acknowledging his feelings and listening to what he says. This communication does not always have to be verbal. Writing or drawing or even making music can get your child to share his feelings.

Encourage him to actively participate in his health care management. Help him to be independent. Once he starts feeling more confident and independent, he will be more likely to share his feelings of living with diabetes. Encourage him to have fun with friends and if he starts going on outings and camps with friends and other children with diabetes he will learn from them that it is okay to talk about it.

  • Tell your son that he did nothing to deserve diabetes – it just happens. If he feels that the condition is troublesome for you or your family, reassure him that there’s no reason to feel guilty.
  • Remember that children are likely to copy the way that their parents cope with something.   Also remember that expecting a child to deal with things quickly and practically isn’t helpful to you or him. You need to set the example.
  • Build a support network that you and your family can fall back on. Be informed parents.
  • Make the most out of every day.

You and your son are on a lifelong journey with diabetes.

A good journey requires lots of planning, flexibility, curiosity, frequent course corrections, and an occasional attitude adjustment.

Make it a good one.

– Jeannie Berg, Diabetes Educator