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November 11, 2010

Ask Joe, Daily Care

Question from Calgary, Alberta, Canada:

You stated in your last response that children should begin to take responsibility for their own diabetic care at a young age - in age appropriate manners. Exactly what responsibilities should a (nearly) 13-year-old boy, who has had diabetes for 10 years, be undertaking? I have a lot of different people giving me a lot of different opinions about what I am doing and what I should be doing. I would like your opinion. I am treating my son's lack of diabetic self-care as disobedience. However, the way that things are going (mostly downhill), I can't help but wonder if I'm not expecting too much from a child. If you could just lay it out that a 13-year-old should... and a 14-year-old should...etc., I would appreciate those written guidelines.


I think you might have misunderstood me regarding young children; I never ever think I said that children should begin to take care of their diabetes at a young age. If I did say that, it wasn’t right or perhaps you misread me.

Things a 13/14-year-old should be responsible for regarding diabetes management:

Remembering to check their blood sugars prior to meals. At the very least, they should be doing at least four blood sugar checks a day. That�s a minimum!

They should record their numbers and corrections and carbohydrate counts in a log book.

They should bolus before meals. Bolusing after meals is an absolute no-no for most of the time. If you bolus after a meal, the insulin and food will miss each other in the blood stream and you’ll have a high number, then a low number because of the missed timing.

If it�s a two parent family, then both parents have to agree on what�s going on and be working together. If one parent is overburdened and the other parent is somewhat peripheral, then, no matter what you do, your child will most likely continue to misbehave in the area of diabetes or if you’re not consistent with the consequences or if you continue to “micro-manage” the diabetes situation.