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April 25, 2001

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Question from Greenwich Connecticut, USA:

I am a working mother with a five year old son who was just diagnosed with type 1 diabetes and requires an insulin shot everyday at 5:30 pm. His 24-year old nanny does not feel comfortable giving him the shot, but I am not sure that I can be home every day in time to give it. What alternatives do I have in providing my son with the care he needs without having to quit my job?

Answer:

Anyone who is routinely taking care of your son needs to be familiar with diabetes and have some training in recognizing emergencies and basic care of diabetes, including giving an occasional injection. I would strongly suggest visiting a diabetes educator along with your son’s nanny to help her become more comfortable with giving an injection. She also needs to know how to prepare and give a glucagon injection, if needed, for severe low blood sugars.

MSB

[Editor’s comment: I wholeheartedly agree with Dr Brown’s comments, and would like to offer a couple of additional suggestions:

Perhaps you can ask your son’s diabetes team to change his schedule so that the evening injection can be given at a time when you can be sure to be home. Moving it to an hour or so later should not make too much difference.
If you haven’t done so already, perhaps you can request a short leave of absence from your job until your son’s nanny feels more comfortable (most employers are required to allow this under the Family and Medical Leave Act (FMLA) of 1993.
I would also recommend arranging to leave work a little early so you can be there in time for the injection.
SS]