Type 1 Diabetes and Sleepovers
Slumber parties are one of the most highly anticipated events of childhood. Apart from time-honored traditions like eating unhealthy food, being silly and watching a lot of bad TV, slumber parties give children a chance to create memories with friends in a way that isn’t possible on play dates after school.
But when your child has type 1 diabetes, the idea of having her or him attend a slumber party can be nerve-wracking. You can’t help but worry about the myriad challenges that could arise, and how they’d be handled while your child is out of your care.
The good news: With some planning and prep slumber parties can be a successful experience for you, your child and the host parent.
Joyce C. Bookshester, MA, PsyD, a licensed clinical psychologist with expertise in treating the emotional and developmental issues associated with type 1 diabetes, encourages this social experience, provided certain criteria are met.
"Having type 1 diabetes requires a specific care program that the host parents need to be comfortable addressing. It’s advisable to call the parents who are hosting and let them know your child has type 1 diabetes and ask them if they would be willing to meet with you previous to the sleep over so that you can get a sense of the carbs they will be serving and demonstrate how your child’s insulin dispersing and monitoring devices work," says Dr. Bookshester. She adds: "If the child’s numbers are relatively stable and the parents are convinced that their child is responsible and competent and skilled in the technology associated with type 1 diabetic management, don’t hesitate. Kids don’t want to be different and want to experience normal childhood events like sleepovers."
Before accepting an invitation to a slumber party, Dr. Bookshester recommends starting with a one on one sleepover—rather than a slumber party. A family member or close friend of yours and your child’s who lives nearby are an ideal choice for the trial run. "The one-on-one sleepover is an excellent way for families to get their feet wet,"she says. "As social networks evolve, slumber party invitations are inevitable and if the family has had practice with sleepover experiences, the big slumber party will be less scary."
If you and your child decide she’s ready, consider the following checklist from Dr. Bookshester’s to help make the sleepover party a success for everyone:
- Reach out by phone to inform the host that your child has type 1 diabetes. The family may decide from this phone call that they’re not comfortable with this responsibility, or you may determine that they are not ready to take this on. Lisa Gibby from Bethesda, MD, a mom of a middle school-age son and a daughter in high school, both with type 1 diabetes, says, “We are always upfront about what type 1 diabetes involves. Most people don’t realize how involved blood glucose management can be. Unless you know the host family very well, it may not be reasonable to expect them to take on the diabetes management piece, too.”
- If the family is on board, set up a time to demonstrate how your child’s insulin dispensing and monitoring devices work. It’s much better if this takes place before the day of the party. You don’t want to risk making your child nervous or embarrassed. And the host parents will also be busy greeting guests and saying farewell to the parents, which means important details could be overlooked.
Also, a host family may be understandably less enthusiastic about the invitation once they are versed in the care. “I like to give written instructions to the host family when we meet. Everything usually goes well until you pull out the glucagon kit. [Glucagon is given by injection to remedy severe low blood sugar.] That’s when you see the panic set in,” says Gibby. “You know they are thinking: ‘What have I signed up for?’ On the other hand, that reaction shows they are listening. In a way it’s a good thing. You almost want to see the panic because you need them to understand how serious diabetes is, while at the same time you want to put them at ease.”
- Find out what carbs they are planning to serve. If your child doesn’t have restrictions with her diet (typical for most type 1 kids today), reassure the host that special food isn’t necessary. Explain that your child can eat whatever she likes as long as she adjusts her insulin doses to the carbohydrates she consumes. If your child is more comfortable calculating her carbs, this can be tricky when labels aren’t available. If she’s comfortable “send her with a scale to help her calculate foods that don’t have labels. Use this formula: Every ounce of bread products and dessert is approximately 15 grams of carbohydrates,” says DiabeticLifestyle Medical Advisory Board Member Amy Hess, MS, RD, LDN, CDE, a program coordinator for the Teen and Adolescent Diabetes Transition Program at the University of Chicago’s Kovler Diabetes Center.
- Have a trial run the weekend before the slumber party. Your child should demonstrate the ability to monitor his blood glucose levels by checking his blood sugar. If your child uses a glucose monitor, he should also know how to use and calibrate it and understand how to count carbs in order to dose correctly. “My biggest problem with sleepovers is the anxiety I have over not knowing the numbers and not being there to help,” says Gibby. “If it’s a full-blown slumber party with a group of kids, crafts and activities, the host parents already have a lot on their hands.” Technology, however, is changing they way parents can monitor their child’s blood sugar from afar. If the child uses a CGM, a parent can access it via phone (and they can have followers receiving the information and alerts/alarms as well).
- If your child requires shots, prepare syringes at home in advance. Having pre-set syringes means she won’t miss out on any fun trying to measure out the insulin.
- Pack those diabetes supplies in a bag that doesn’t scream “medical supplies.” Some children don’t want to share their diagnosis with friends and may not want to call attention to medical supplies in a medically marked kit. Try packing supplies in a kid-friendly tote. To store insulin, one of these insulated bags with kid-friendly designs can go a long way toward making your child feel comfortable. Or you can purchase a plain insulated bag and have your child decorate it herself.
Your overnight bag should include the following:
- a blood glucose meter and extra batteries
- ketone test strips with instructions on how and when to use
- glucose tablets; orange juice or whatever your child normally uses to treat low blood sugar
- insulin (unopened insulin should be packed in an insulated bag)
- extra syringes and insulin if your child uses a pump in the event of a pump failure
- the personal data manager (PDM) if using a pump
- charger for their continuous monitor
- a Glucagon kit (with instructions on how to use in case of a low blood sugar emergency).
- Reassure a nervous child that you are available at any time for an unplanned pick-up. Make sure your child and the host parents know that you can be contacted at any time during the event if there is a problem or if your child wants to come home.
- Leave behind the set of written instructions you reviewed in the first meeting. You might also email them to the host so that can easily locate them and also have for future reference.
- Anticipate problems and plan accordingly. Make the family aware of what low blood sugar looks like and the symptoms to watch out for (shakiness, confusion, slurred speech, etc.). If blood sugar numbers aren’t looking good at bedtime you may want to pick up your child rather than ask the host parents to check blood sugar in the middle of the night. You can always bring her back in time for breakfast in the morning.
Have a Plan B…Just in Case
At any point leading up to the sleepover, Gibby says, “if I detect wavering on the part of the parent, or I begin to have my own concerns—either about the parents’ capacity to handle it or because I don’t want to be a burden—I’ll offer to move the sleepover to my house.”
If the host bows out or an acceptable solution to your concerns can’t be worked out, Dr. Bookshester says it’s best to give your child an honest and empathetic response based on her maturity and feelings about having diabetes. “Rejection is always painful, but it’s also a part of life. As with other chronic conditions, there are sleepaway camps for kids with diabetes all over the country. They can be a great alternative to hosting a sleepover or sending your child on one,” says Dr. Bookshester.