My five year old son, diagnosed with type 1 diabetes three weeks ago, is on insulin shots three times a day, but he refuses them. He hides in closets, and I have found him hiding in the fifth floor of my apartment building. I speak to and negotiate with him, but I am devastated. I would highly appreciate any advice to make this easier on both of us.

It is very common for young children to be afraid of insulin injections and to try and run away from them. Although it is common, it is not acceptable, as insulin is vital for his health and safety. In addition, by running away and hiding, and by having you chase him, plead with him, negotiate with him, and beg him, he has managed to figure out a way to keep your 100% undivided attention. He has also figured out that it is the diabetes care that allows him the ability to keep your 100% undivided attention. This is not a developmentally normal or appropriate method for getting a parent’s attention.

Given all of this, it is vital that your son learn that shots are non-negotiable. They are business. This is business that keeps him healthy and safe. The business gets done quickly, quietly, and without conversation. Once the business is completed, he can run, play, laugh, and ask for your attention, etc – but not until the business of shots is completed.

Although it sounds somewhat cold-hearted, the best solution is as follows: First, prepare everything you need to be ready for his injection before you bring him into the room – that way, you have minimized the amount of time he is spending anticipating the injection. Second, have one adult hold him while the other adult gives him his injection. Do not speak to him during this time. Do not negotiate with him. Do not give him the opportunity to run away from you. He will likely yell, scream, cry, etc. However, the amount of time it will take to give him his injection should be less than one minute.

Once the injection is over, praise him, hug him, kiss him, tell him how proud you are of him, and then focus his attention on something other five year olds do, such as playing a game. Children never struggle more than one to two weeks when parents are consistent with this behavior plan. They soon learn that the injections will occur whether they want them to or not, and they also learn that diabetes is not the reason for getting extra attention. Good Luck!

JWB

[Editor’s comment: See a previous question on this topic.

SS]