Our son is 5 years old and was diagnosed with Type 1 diabetes 2 months ago. My husband believes that he should know that serious complications could arise if he does not closely monitor his blood sugars — including the possibility of death! I think that he is much too young to be given that much information. I am concerned that he may constantly be worried about the possibility of dying when we encounter any obstacles in his course of treatment. What are your thoughts? At what age do you believe this amount of information should be given?

Fear is absolutely never an effective strategy for motivating adherence to a complicated medical regimen. Moreover, it will likely cause your young son undue anxiety without any way of really understanding what the anxiety is about. You and your husband are totally responsible for all aspects of your son’s diabetes regimen, so he should not have the choice about monitoring blood sugars anyway. In fact, until he is an adolescent, you and your husband will be primarily responsible for adherence to the regimen, not your son. Once he shows developmentally appropriate responsibility and judgement, the responsibility will be shared among you.

Finally, no one with diabetes is capable of keeping blood sugars between 80 and 120 all of the time, so setting unrealistic goals only sets everyone up to be miserable and feel like a failure.

I suspect your husband’s own anxiety is making it difficult for him to remember that your son is a child first, and it is also preventing him from enjoying the pleasures of parenting. Perhaps meeting with a mental health professional (your diabetes team can probably refer you to one with expertise in diabetes) will be helpful in learning ways to manage the anxiety without harming your son.

JWB