When should diabetic kids begin taking on their own care?
A Windsor paediatrics manager says a child's capabilities, not just age, should be considered
Janice Wirch learned her son had Type 1 diabetes when he was three years old.
Nearly 16 years later, Brayden, now 19, is managing the symptoms on his own.
Wirch, from Tecumseh, Ont., said she was first tipped off there may be a problem with his health when he had excessive urination, occasional vomiting, and gradually thinning out and losing weight.
"As you know, toddlers change so drastically that really the signs weren't really that prominent, but the excessive urination," said Wirch, who eventually got a diagnosis at Windsor Regional Hospital.
LISTEN | How do we know if our toddler has diabetes?:
Other symptoms: "Irritable .. I think fatigue, vomiting, irritability, weight loss, just, you know, gaunt looking and dark eyes. And I think you feel something's wrong."
Once diagnosed she said life changed drastically for her family.
"It was a new normal. I think it just called for a lot of discipline, a lot of structure in our day. You know, between finger pokes, checking blood sugar and four to five injections daily and eating on a regular basis."
Gradual transition of care control
Wirch said her son was then able to know when to stop playing and eat, or get an injection.
Since then, she added, he's been gradually brought into the fold of his own treatment during adolescence.
"As he got older, I looked for signs for him to help take on some of the responsibility and maybe just being aware of how he felt and being able to communicate that to me."
However, despite his diabetes care primarily under his own watch, Wirch said she still plays a role.
"Even though he's 19 now, we still don't leave all the care in his hands, and we still share that just so there's not a lot of fatigue."
According to Wirch, communication is paramount.
"I think it starts … understanding that he has to think in advance before he exercises. Just be mindful of going low for any emergency situations and being able to communicate that and communicating to other people. Other people need to be aware you have diabetes. Just in the episode of an emergency."
LISTEN | Managing childhood diabetes:
Brandon Garant said it's not entirely an age thing for when you should begin transitioning care to your diabetic child — and that it's also dependent on the child's capabilities.
"Some of these kids are great at school ages — I'm talking eight, nine, 10 — to be involved with their care," said Garant, who's the clinical practice manager for the paediatrics department at Windsor Regional Hospital.
He said diabetic kids should have some parental involvement for supervision but there's no reason why a "school age" child can't be involved with their own care.
"But really, until you're at like the adolescent teenage years, the family has to be really involved. Once they get to the teenage years, they can be solely or majority responsible for their care activities, which includes checking the blood sugar and administering insulin."
Tech helps transition
Wirch said technology continues to play a role for her family as it relates to diabetes — and provides an extra layer of comfort — citing things like medical alerts, insulin pumps and monitoring apps.
"With the continuous glucose monitor … that is received through his phone … We actually are able to view it on our phone as well, so it can alert us during the night or during the day, even when he's not with us. We know what his blood glucose is."
Wirch said compared to the toddler years things have become much less vigilant in terms of tracking.
"The night can be … that's a long period of not knowing what their blood sugar is. I think with the technology today, we have a lot of glucose monitoring that can be done. So that's just been a game changer for Type 1 diabetes."
Garant said if a child isn't diagnosed early on their symptoms will continue — then worsen.
"As your body needs insulin to break down sugars and move it into the cells, so if it's unable to do that then it starts breaking down fats in the body and uses them as a fuel source," he said.
"If it was left untreated, they began to get lethargic … a lot more tired than usual. They may start complaining of stomach aches. It could be life threatening."