My seven-year-old brother was just diagnosed with type 1 diabetes this morning and my mom is not sure how to explain this to him in a manner that won’t scare him. He throws a fit every time he had to be injected with the I.V. or have his blood taken. Knowing that he will need insulin shots following treatment in the hospital after a couple of days, is there any way to tell him about his condition and what we have to do (give the shots and blood sugar count) in a way that will ease his fears?

What seven-year-old (or anyone for that matter) likes the idea of needle sticks and on-going medication?

Children are remarkably resilient. In my mind, the MOST IMPORTANT thing the family can do is be supportive, but firm. There are no “negotiations.” Insulin must be given! Blood sugars must be checked.

Getting a child psychologist or psychosocial worker involved early may be helpful. But, if the parents (or siblings) have a “oh-woe-is- me” attitude, the child will also.

There are some things that you can do to make the issues less so: try using the injections with either a needle guard or an Inject-Ease which “hide” the needle. Also, some of the newer glucose meters can use alternative sites (such as a forearm) which are not as sensitive and hurt less.

DS
Additional comments from David Mendosa, A Writer on the Web:

Tell them about the Pelikan Sun. It will reduce the pain of blood glucose testing to practically nothing.

DM
Additional comments from Dr. Andrea Scaramuzza:

Facing a new chronic condition is always difficult, even more for a little child only seven years old. I really don’t know any proper way to let him accept his diabetes, if not making him feel loved and cared as usual. The most important thing, in my opinion, is to let him know that having diabetes is not his own fault and nobody is responsible for that thing if not fate.

Together with a friend of mine, Professor Ludvigsson from Linkoping, we have written the following simple rules, that are not “a guide about what to do,” but could be just a suggestion.

The Insulin, Love and Care Project: The new way to view diabetes and, above all, build trust between doctor and patient.

There is no such thing as bad diabetes, just one that is difficult to manage. Diabetes is not only an enemy to overcome, but can also be a partner who is demanding with whom you have to and can learn to live.

Being happy is more important than living a “normal life.” It helps to face diabetes with a smile. And while not neglecting it, a patient can do most of what his friends can do.

Good self-care is a must. Gradually, with age, a child should learn to manage his/her diabetes in order to become more responsible and independent.

Hiding one�s diabetes doesn’t do anyone any good. Diabetes is not a disease that should be hidden. Talking to others about diabetes helps to accept this condition, and become more relaxed.

Knowing that poor control is our common fault makes cheating unnecessary. It is not only your fault if the treatment result is poor! The team/your collaborators and you have a common responsibility. We rely upon you. Cheating is to give up!

Having relaxed parents by your side is important. Your parents must be supportive without being invasive or overly protective.

Teachers and educators have an important role. The people who spend time with the child or adolescent on a regular basis must not keep him from being himself. That attitude often makes the child feel “different.”

The doctor is not just a mechanic for the body.The doctor should not limit himself to deal with the disease, but also care for the person burdened with questions and fears, anguish and hopes.

Doing it together is easier than by yourself. Facing the condition together with others is certainly easier. It helps you feel less alone, encourages a dialog with those who share your problem, and helps you follow the rules imposed by diabetes.

To live with diabetes does not mean a “normal life,” but a long, exciting, happy life! Diabetes is something to live with. Do not fight, but learn to live together as friends.

Tell your brother that he is still a brave boy and doesn’t need to be afraid because of diabetes.

AS
Additional comments from Debbie Butler, MSW, LICSW, Licensed Clinical Social Worker:

First, your parents should see if there is a social worker or other mental health counselor on the floor with whom they could discuss some of their concerns. There are also some children’s books about diabetes that I have recommended to families, which might be helpful to read to this child. The two books I like the most are Rufus Comes Home and Taking Diabetes to School both by Kim Gosselin.

DB