When your child is first diagnosed with diabetes, you may spend a lot of time thinking about how diabetes affects your child's body. But there are many emotional issues that surround a diabetes diagnosis, too. The emotional transition that your child goes through after he or she has been diagnosed with diabetes may affect his or her ability to manage the physical aspects of the condition.

So it's important to recognize the feelings that your child with diabetes might experience and learn strategies to help your child and your entire family cope with them.

Your Child's Feelings

Kids often experience these emotions when they are confronted with diabetes:

• Isolation: Diabetes can make kids feel different from peers, friends, and family members. If your child doesn't know other people with diabetes or he or she is the only one who needs to visit the nurse for injections or blood tests during school, your child might feel isolated or alone.
• Denial: Because kids want to blend in or be like other kids, they may sometimes pretend that they don't have diabetes, a practice that can be dangerous if they avoid blood sugar testing and medication.
• Depression: Feelings of depression, sadness, and hopelessness are common among kids with diabetes. Your child may cry a lot, feel exhausted, have changes in eating or sleeping habits, or have a hard time sticking to the diabetes management plan because he or she is depressed.
• Guilt: Some kids may feel like diabetes is their fault or like they're causing problems for parents, siblings, and teachers because of their diabetes.
• Anger, frustration, and resentment: Your child might be angry at you because you oversee testing and treatment or frustrated or resentful that he or she has the disease and others don't. Many children feel angry because of the restrictions that diabetes sometimes places on their everyday activities.
• Fear and anxiety: Blood sugar control problems, needles, and the potential for long-term health problems can be scary prospects for kids to deal with. And in some cases, fearfulness can be the result of incorrect information kids have received about the diabetes.
• Embarrassment: Kids with diabetes can feel embarrassed about the extra attention they get, like when they're testing blood sugar and injecting insulin at school, at friends' homes, and in front of other kids.
• Dependence: When kids find out they have diabetes, they may begin acting younger than their age and depending on parents more than their peers. The progress that they'd typically be making toward self-reliance can stop or reverse course.

Your Feelings

Parents often go through a grieving process when they find out that a child has a disease like diabetes. It can be difficult to come to terms with the idea that your child has a chronic condition and will need to cope with it for the rest of his or her life. It's normal for you to feel grief and sadness.

Many parents also feel guilty about their child's diabetes and wonder whether they could have prevented it in some way. Some parents may also feel reluctant or unsure of taking on the tasks of caring for a child with diabetes, such as administering medications and helping their child follow a meal plan. Parents may also worry whether they'll be able to recognize symptoms of a diabetes problem and get the right medical help for their child.

What can you do to cope with your own feelings? First, don't hesitate to get the answers to your questions from the health care professionals caring for your child. Educating yourself about your child's condition and the best ways to manage it can do a lot to put your mind at ease. Your child's doctor can provide information to allay your fears and worries and offer tips for coping with your child's emotional issues.

In the midst of caring for your child, don't forget to attend to your own needs. Get appropriate rest, exercise, and food. To the extent possible, permit others - like relatives and friends - to share the responsibilities of caring for your family. Remember that you can't do it all.

Your Family's Feelings

When a child has diabetes, it affects the entire family. Siblings may feel resentful of the extra attention that your child with diabetes is getting, as well as any sacrifices (like eating healthier foods at meals or going along to doctor appointments) they may have to make to accommodate the sibling. Siblings are sometimes the target of a diabetic child's anger and resentment because they don't have to deal with the issues that the child with diabetes faces every day.

Family members like grandparents, aunts, and uncles may also be worried and fearful about your child's health condition. Try to talk openly about all of these feelings with your family. Holding a family meeting might be one way to break the news of your child's diagnosis and address the worries and concerns of family members. You might find it easier to talk with a counselor or the doctor or diabetes health care team about the feelings that you and your family are coping with. Your family may also find comfort in support groups, books, and websites about how to deal with diabetes. In time, the whole family will become accustomed to dealing with this condition.

Tools for Helping Your Child

Once you learn to recognize the feelings that your child with diabetes may experience, there are steps you can take to help cope with those emotions.

Acknowledge your child's feelings. Check in with your child regularly about his or her feelings about diabetes. Try to listen to everything your child has to say before bringing up your own feelings and explanations. This kind of communication doesn't always have to be verbal. Drawing, writing, or playing music can help a child with diabetes express his or her emotions.

Encourage your child to play an active role in his or her health care. It's important to regularly reinforce the idea that when kids take good care of themselves and manage their diabetes, they can avoid undesirable things like extra shots or sitting out of activities that their friends and peers are doing. Your child may even want to ask the doctor questions on his or her own.

Emphasize independence. It may be difficult, especially at first, but it's important to resist the urge to lower your expectations or overprotect your child who has been diagnosed with diabetes. Rather, it's important to encourage the same independence that you'd expect from your other children. If young people have the encouragement and support of their parents, they can take on some responsibilities for managing diabetes - a change that often has a positive, confidence-building effect.

Help your child find his or her strengths. Help your child form a strong picture of his or her identity. Who is your child? A reader, a hockey player, a son, a daughter, a grandchild, a student, a future astronomer, or an art lover? Your child is also a person in control of diabetes, but this does not define a person's life - it's only a very small part of who someone is.

Focus on friendships. Encourage your child to have fun with friends, which builds confidence and a sense of belonging. Your child should know that it's OK to discuss diabetes with friends. Instead of focusing on the one thing that's different, kids can focus on all the things that they have in common with their peers.

Find ways to cope with bullying. Sometimes kids pick on children with diabetes or other health problems. Your child might use the following ways to deal with teasing or bullying:

• Act brave, walk away, and ignore the bully. Tell your child to look the bully in the eye and say something like, "I want you to stop right now." Counsel your child to then walk away and ignore any further taunts. Encourage your child to "walk tall" and hold his or her head up high (using this type of body language sends a message that your child isn't vulnerable).
• Use humor or give the bully a compliment to throw the bully off guard. However, tell your child not to use humor to make fun of the bully.
• Use the buddy system. Enlisting the help of friends or a group may help both your child and others stand up to bullies.
• Tell an adult. If your child is being bullied, emphasize that it's very important to tell an adult. Teachers, principals, parents, and lunchroom personnel at school can all help to stop it.

Dispel misconceptions your child may have. Talk to your child about the fact that people do nothing to deserve diabetes - it just happens. Also, if your child feels like his or her diabetes is problematic for you or your family, reassure your child that he or she doesn't need to feel guilty. Remind your child to focus on dealing with his or her own feelings about diabetes, not yours.

Tell friends, teachers, and peers about your child's diabetes. Kids sometimes find it less embarrassing if they tell friends and classmates that they have diabetes - that way, they don't have to worry what their friends will think when they head to the nurse's office every day. Talk to your child about how he or she would feel if other people knew about the diabetes. Your child's teacher or child-care provider should also know about your child's condition and steps he or she might take to manage it (like taking breaks to test blood sugar or eating snacks at certain times).

Connect with other children and families dealing with diabetes. Finding a support group for kids and families with diabetes can help to connect your child with other kids with diabetes so he or she feels less different. These groups can also help you bolster your confidence as you deal with diabetes and offer advice and tips as you manage your child's health condition. Your child's diabetes health care team may be able to help you connect with support groups in your area.

Get help when you need it. Be sure to keep your child's diabetes health care team in the loop about any emotional issues - they deal with this all the time, and they can provide help for your child and advice for you. If your child seems to be suffering from signs of depression, such as prolonged sadness or irritability, fatigue, appetite changes, or changes in sleeping habits, talk to your child's doctor or a mental health professional.

Every parent of a child with diabetes must deal with the feelings that surround the disease. Try to keep in mind that most of kids' negative feelings about diabetes pass or change with time as they adjust to living with diabetes.

Reviewed by: Steven Dowshen, MD
Date reviewed: September 2007