A knock at the door, with a friend asking if a child can come and play, typically brings much needed relief to parents from the litany of complaints a pent-up child may have: "I'm bored!" "There is nothing to do!" "Why won't you play with me?" "Why can't I watch more TV ...?"
When that knock comes, parents hold the screen door wide, shouting a robust "Go!" trying to restrain their relieved giddiness as the child darts out the door.
The same is not true of a knock at the door when your child is diabetic. For me, a knock at the door now makes my stomach fall out when the request is for my oldest son, who is a Type 1 Diabetic.
I understand that letting go is never easy, but I never equated this with something as simple as allowing him to go out for a bike ride or to the neighborhood pool with a friend. I try to mask my hesitation as I weakly say "yes," when he asks to go.
Yet, when a parent of a diabetic child thinks about it, simply letting their child go out and play could result in a very low-low and a call to 911, or a teenager sugar-binging with friends (or worse) and ending up in the ICU with DKA. When we stop and consider the possible complications, it's almost beyond us to allow our children out of sight for any unsupervised activity.
I have to admit, there are times that I would love to encase all three of my kids in their own plastic bubble and ensure that each remains safe. However, I have come to realize that being "hyper-protective" can backfire on me. I've found that not allowing my diabetic son to go on a fairly routine outing, like for a walk around the neighborhood, results in him feeling angry with me; with his condition; and at times resorting to rebellion, like going out without his diabetes materials.
That's why I feel as if saying "yes" to a request to go and play helps a diabetic child know that he can take some part in owning the management of his diabetes and be accountable and responsible in working with others outside of his usual family and school support circle to ask for help if he needs it. Too, it confirms to these children that they have the right to play and have fun just like their other playmates. We work so hard to ensure that they have a right to equal education at school, so we should work to help them have a similar experience in their social life.
The first step to ensuring such a safe experience is to educate all that may be involved. If your child is going to another playmate's home, call the parents and explain your child's condition. If children are older and can better handle and comprehend the diabetes and symptoms of a BG low, then ensure that both the parents and the playmates are aware of how your child (their friend) acts when they're experiencing a blood sugar low and how they can help out, whether it be to help your child have a simple snack or something more complicated such as helping with an insulin shot. If you want to be on the safe side, provide any and all necessary snacks, complete with serving size, and ensure that the parent who will be chaperoning understands what to do if your child experiences a low.
Sending glucagonsor insulin will be dependent on your own decision, where your child will be going to play, i.e. how far away the outings is and how long it will be.
A useful tool is to compile a one-page overview of the both hyperglycemia and hypoglycemia, complete with your child's specific symptoms and how to treat him if he is experiencing either. If your child simply is going out to play on your street or neighborhood with friends, ensure that all parents of playmates are aware of your child's condition, which can be done via email.
Have a diabetes supply bag (or "D bag" as many parents affectionately call it) that can fit whatever your child uses to manage his condition, including a blood glucose monitor, syringes or needles, insulin pens, alcohol wipes, glucose tabs or a snack and a few dollars in quarters in case he wants to buy water or a snack. The supply bag should be small enough as to be unobtrusive and attractive enough as to not be embarrassing. I have yet to find any sleek, masculine, low-profile bags for my son, but a company called Skidaddle Bags out of Florida offers bags for girls, and soon will expand its offerings to include bags for boys.
A plan of action of what to do if something does go wrong can prove particularly helpful for the older child that can at least recognize signs that he may be going low or high and role play with him as to what he might do. Think of the various situations your child may be in and play act with him, asking what he might do and making suggestions for alternative courses of action if his responses aren't the safest.
A cell phone for the older set is a key asset. This way you can allow your child more freedom knowing that you can stay in touch via cell or texting. If it makes you feel better, set up a schedule of what times he will check in with you. For example, when my son goes to the pool, I ask him to text me every hour when they break for adult swim. On one occasion, he forgot to text me and missed my follow up phone calls because his phone was on buzz. But the mortification of my then showing up at the pool and storming over to the block of lounge chairs that he was occupying with his bevy of friends has resulted in him texting me at every agreed upon time-like clockwork!
Why should we let them go play? If we don't, our children will not be able to take ownership of the management of their condition. As with any child, sometimes giving a little rope so he can experience what to do if something is not going according to plan can mean that he becomes more self-sufficient and independent in managing his diabetes. If he does start to have an issue, even if it is as simple as him playing in the front yard next door and noticing low blood sugars and coming home and telling you that he is low, this can go a long way to him building confidence in understanding himself, his body and how to manage his condition.
The toughest thing to do when your diabetic child asks: "Can I go out and play?" ... is answering: "OK."
I've found this to be so very hard, but for the best.
Published On: June 04, 2009