One of the worst fears for any parent is their child being diagnosed with a serious chronic illness like diabetes. This diagnosis can be truly heartbreaking, but the initial emotions are just the beginning. Parents must accept this reality and take on an even greater responsibility than the already immense task of raising a child.
Managing the Diagnosis
As an adult, the best way to handle bad news is to confront it head-on, understand the truth, and take the best possible actions. However, with a child, especially one as young as 12, this approach can be too harsh. Parents need to accept the extra work and emotional baggage to make their child’s life as normal and healthy as possible. As the child approaches adulthood, they should be taught how to manage their condition effectively.
Family Support and Dietary Changes
A crucial step for families is to support the child by adopting a diabetic-friendly diet themselves. This means that all household members should eat as if they were diabetic. One effective intervention is a low-carbohydrate diet, such as the ketogenic diet. This diet helps make blood glucose levels more predictable, which simplifies insulin dosage calculations. By eliminating dietary sugar as a variable, parents can keep their child’s blood sugar levels within a target range of 90-110 mg/dL.
Psychological Toll During Adolescence
The psychological impact of diabetes often intensifies during the teenage years. Adolescents, who are transitioning to adulthood, may rebel against the disease and strive to feel normal. The visibility of measuring glucose and injecting insulin can make them feel weak or biologically inferior. It is not uncommon for high school students to skip insulin injections, claiming they have outgrown their diabetes. Unfortunately, this can lead to severe diabetic ketoacidosis (DKA), hospitalization, and lasting biological harm.
Preventing Severe Outcomes
Tragically, many teenagers end up critically ill in the ICU due to severe DKA from apathy or rebellion. Some may even attempt suicide, unable to cope with the burden of their disease. These are often good-hearted children who do not want to be defined by diabetes and try to ignore their condition. A single severe episode of DKA can cause permanent organ and brain damage, and even mild DKA episodes can have long-lasting health consequences.
The Importance of Mental Health Care
Properly managing diabetes requires diligent care, monitoring, and planning, which necessitates a stable mental state. To support this, psychotherapy and long-term pharmacotherapy with SSRIs, such as sertraline, should be initiated at the time of diagnosis, even if no psychiatric issues are currently present. Starting mental health treatment early can prevent apathy or rebellion during adolescence. The psychological stress of diabetes needs lifelong management, but children are especially vulnerable to catastrophic outcomes.
Understanding Chronic Illness and Mental Health
Parents should not feel like failures. Chronic illnesses like diabetes or multiple sclerosis cause chronic inflammation, leading to biologically explained dysthymia. For those without chronic illnesses, the decrease in well-being experienced during the flu is due to inflammatory molecules. Individuals with chronic illnesses feel this way all the time due to higher baseline levels of inflammatory cytokines. Therefore, using antidepressants should be seen as restoring normal neurochemistry, not as a sign of weakness.
Conclusion
A diabetes diagnosis in childhood brings immense challenges, both physical and psychological. By supporting their child with dietary changes, establishing early mental health care, and understanding the biological impacts of chronic illness, parents can help their child manage diabetes effectively. This proactive approach can prevent severe complications and help children lead healthier, more fulfilling lives.
