When I read Dr. Fran Cogen's most recent post about having a "supernanny" be a part of a child's diabetes management team, the post struck a cord with me.
At first, the thought of a "supernanny" brings to my mind the image of the bespectacled British woman swooping in to right a very wrong family situation when the child (or children) have commanded control and the parents are either unable or unwilling to wrest that control back. Initially, I take offense to the show on many levels: annoyance and ultimately frustration at the parents for being unable to control their children and disbelief at the unbelievably awful behavior that these kids are able to get away with.
When I stop and take a step back, I realize - to my astonishment - that at times I can relate to the parents and why they're doing what they're doing as well as understand the kids and why they are acting the way the do. I can relate particularly when it comes to myself and working with my oldest son to manage his Type 1.
As I've confessed before, my husband and I have been pretty fortunate when it comes to our son (who is now an adolescent) assuming responsibility for diabetes care and management, which is light years away from what is required of parents with toddlers or young children with diabetes. Yet even with our son taking on much of his diabetes care, we, as parents, certainly have "fallen off the wagon" on more occasions than one when it comes to monitoring the day-to-day demands of Type 1.
Here are the times that I've found that I've typically relented when requiring adherence to the daily management routine:
- When I feel guilty: Since diagnosis, I've been guilt-ridden that somehow my son's condition is my fault and also about my inability to make his diabetes go away. Realistically, I understand that this is a ridiculous way to feel, but I often compensate by letting my son "go ahead and have that second cookie" while at a party with friends ... because "everyone else is doing so ..."
- When I feel burned-out: Diabetes never, ever takes a day off, which can wear all of us down. It's when I'm at my lowest that I let my guard down and say "Don't worry about checking or shooting or whatever, it'll be OK this once ..."
- When I'm pushing my son to have more independence: This is where I've fallen flat on multiple occasions. My son is very independent about his care, but not so great about recording keeping, at times even fabricating BG checks to keep me happy. I, ever too trusting, don't check records as I should and the vicious cycle begins.
There is no doubt that at these times I'd love to have a supernanny, or better yet "coach," help both me (as a parent) and my son through these and other hurdles that we come up against during the routine and mundane events of living. For it's navigating these daily hurdles - in effect changing both of our behavior -- that will have a cumulative effect on my son's long-term health.
Such a person on a diabetes management team would be invaluable to parents and kids alike. Many people currently on the diabetes management team try to fill in this role: the endocrinologist or primary care doctor, the CDE, the counselor (if available), even the nutritionist. But to have one person dedicated as a go-to, helping us change our bad behavior and get over those hurdles would make our team and management regime that much stronger.
At the heart of role of such a supernanny or coach is behavior change, which can have the biggest impact in the long run on anyone's health, whether managing diabetes or some other health condition. Consider weight control or smoking cessation or changing exercise habits or any of the issues at the heart of the health and wellness trend sweeping across the country: these are all based on behavioral change. Yet I don't think we as a country put enough of a premium on stopping the causes of problems at the root. Rather, we'd prefer some new drug or device to treat the problem after the fact - the more spectacular and cutting edge the solution, the better. This is why I worry that there may be less demand to including such a player on the diabetes management team because he wouldn't lend himself to spectacular solutions ... just stopping the problem before it gets to a crisis point.
Maybe the solutions won't be spectacular, but effective. And in the long run, that's what counts.
Published On: July 26, 2010