Age-Related Guidelines for T1D Responsibilities

Type 1 diabetes involves lifelong, daily management. When a child with type 1 diabetes is young, their parent or caregiver takes on most of the responsibility of the child’s day-to-day care. As the child grows older, he or she is able to become more involved in managing their diabetes and will ultimately become responsible for all aspects of their day-to-day care. Children should be encouraged and supported to gradually assume more responsibility in their diabetes self-care as they mature and demonstrate the confidence and ability to do so.

Different factors play into when a child is able to start taking on more of the day-to-day responsibilities, such as:

Age of child
How long it has been since their diagnosis
Their willingness/interest to take on more responsibility
Their level of independence
Their overall understanding of diabetes

General guidelines for recognizing certain diabetes management responsibilities that kids may be able to do for their age.

5 years and younger:

Children in this stage rely solely on their parent/caregiver for diabetes management, however there are ways to include them to help encourage and facilitate autonomy at an early age.

You can include the child by allowing them to:

Choose which finger for blood sugar checks
Help set up supplies on table (meter, tubing, test strips, etc)
Turn on glucose meter/insert strip
Choose the injection, pump, or CGM site
Help count to 10 before taking out the pen/syringe

6-8 years old:

Wipe and prink finger for blood check
Begin learning about carbohydrate content of foods (which are higher vs lower)
May be able to recognize symptoms of low blood sugar and report to parent/caregiver
May begin to help with injections
May be able to give pump bolus with supervision

9-12 years old:

Can perform all steps of checking blood sugar (some may need supervision)
Recognize symptoms and treat low and high blood sugar
More independent with pump boluses or injections, but supervision is needed
Can make food choices and learn to count carbohydrates

13-18 years old:

Mostly independent with shots, insulin pump management and blood sugar tests, but still need adult supervision/input if any changes need to be made to insulin dosage
Identify appropriate foods to eat, plan meals/snacks, and can count carbohydrates
Recognize symptoms and treat low and high blood sugar
Demonstrate a greater understanding of the importance of blood sugar control to prevent future complications

It’s important to keep in mind that each child is different, and they develop and mature at different rates. A child’s ability to perform self-care tasks depends on their level of maturity, capability, and willingness to assume responsibility of their diabetes management.

How to know if your child has been given the right amount of responsibility:

They demonstrate an understanding of diabetes
They are adhering to the diabetes management plan
They have good blood sugar control
They do not experience frequent medical complications requiring hospitalization

Transferring diabetes care tasks from adult to child will most likely involve a little trial and error. Remember to keep an open line of communication between you and your child about the division of responsibilities and make adjustments as needed.