My 11 year old son, who has had type�1 diabetes for seven years, is not very reliable about taking care of his diabetes regimen. He can do most of what he needs to, but I can’t trust that he will. When is it time to hand over the reins? How do I transition diabetes care from being my responsibility to being my son’s responsibility, without causing blood sugar chaos?

Great question, and course, the passing of the baton is different for individuals. While it is tempting for you to say to your near-adolescent, “Here, this is your diabetes! You need to be responsible!”, and while you are probably tired of cajoling him (and he’s tired of being harassed and of having diabetes), I’d say do not hand over the responsibility now. You still prompt him to brush his teeth, do homework, clean his room, write thank you notes, etc., etc. Why would you think that he will be more responsible about this? In addition, you noted yourself that he is not very reliable. Some teens need even more supervision when it comes to diabetes, while some children and teens are very mature.

I think that this issue is an important one, and one that can really escalate. For that reason, I would suggest that you talk with your son’s diabetes team about having him (and you and the other parent) attend some sessions with a counselor. A group session for teens may be available from the regional children’s hospital.

Attending diabetes camp in the summer is also a good way to have children garner more self-reliance.

DS