Diabetes on the Spectrum

April 4, 2023

What do you do when your Type One is also Type Au-Some?

I mean, we are all awesome, right?

But, what do you do if you have neurodiversity in addition to type one diabetes?

April is Autism Acceptance Month and at Children with Diabetes, people with neurodiversity and autism (or other forms of neurodiversity) are Type Au-some! We understand that adding neurodiversity into the mix can sometimes make dealing with diabetes more complicated. As a parent to 13-year-old twins, one with diabetes and one with autism, I’m certainly familiar with the challenges of managing each condition individually. At our Friends for Life conferences, our Type Au-Some individuals and families who are living with type one and neurodiversity gather together to form their own tribe to share their highs and lows and form a support system where they share tips and tricks and best practices for getting through the long days and sometimes even longer nights with diabetes and a brain that functions a bit differently. While the list below is not exhaustive, we know that YOU likely ARE exhausted! We hope that these tips will help to solve some of the challenges you may be facing with a neurodiversity + diabetes combo situation in your own homes.

Sensory Sensitivity Issues
Individuals with neurodiversity may be hypersensitive to certain clothing and may not be able to tolerate the feeling of “something extra” being attached to their body like an insulin pump or a continuous glucose monitoring system. When people with sensory issues to clothing have to wear something that is uncomfortable to them, their nervous system (brain) is constantly on high alert and they can receive uncomfortable stimuli on their body. As a result, the brain can become overworked and exhausted, which can result in sensory meltdowns and other behavior related issues. A suggestion for individuals who are Type Au-Some is to allow the individual to use multiple daily injections until they are able to become comfortable with the feeling of an insulin pump and resolve the feelings of sensory overload. Work with your provider and your diabetes care team, try to attend an insulin pump information session and check out the different pump styles. Hold them in your hands and feel them against your skin and attach them to your waistband as a trial. If you aren’t comfortable pumping insulin yet, that’s ok! There’s not a rush and you can always work towards pumping or a CGM at a future visit.

Food Aversion Issues
Some individuals with neurodiversity have sensory aversions to certain foods and will limit foods that have specific textures and tastes. When dealing with low blood sugars, this can be a challenge to locate the perfect food item to quickly bring up a low blood sugar that will also satisfy a sensory need, as well. On top of the physical symptoms many experience, social pressure and judgment around eating and food choices can also be issues, as well. Tips to address food related sensitivity issues can be to avoid trying to “fix” eating challenges and instead getting to know sensory preferences and providing and recommending food choices in an environment that feel safe and comfortable. Make safe and preferred low treatments easily accessible and available. If you find a low treatment that works for you, STOCK UP! You never know when supplies will run low and the last thing that you want to do is to try to introduce a new food during a stubborn hypoglycemic event.

Social Challenges
Let’s be clear. Social activities and social interactions are hard work. For all of us. They can be especially hard for people with neurodiversity. Growing up and living with diabetes requires a certain level of social explanation and social interaction about the devices that we wear and the tools that we use to keep us alive on a daily basis. We tailor those explanations on our audience and provide more or less detail, as needed. For those that are neurodiverse, knowing what to say, in the right way, at the right time and to the right person take a lot of focus and energy. These conversations can be mentally exhausting-for all of us, but, especially for our Type Au-Some tribe members. We can help to manage social fatigue by helping to practice elevator speeches at home. Develop a 30 second elevator response about your diabetes and your devices that you would share with a stranger or even a friend. Practice it often so that it becomes comfortable to you and will be more natural when you need to use it in public. Plan for short social outings with a pre-planned stop time and allow for an escape to a quiet room for a break, as needed. Even the most extroverted person needs a break sometimes!

From one, Type Au-Some mama to you…I hope that these tips are helpful. As we continue to grow our Type Au-Some tribe at CWD, got a tip to share with us? We’d love to add them to our secret stash of helpful hints! Email me at [email protected] and I’ll be sure to tuck them away in my heart and add them to the list immediately.

You’re doing an amazing job, neurodiverse friends and family for life.

Green and orange forever,

Written by Leigh Fickling, JD, MEd, MS