The age range of 10–13 years is often referred to as the “tween” years. Most tweens this age can check their own glucose levels, have an understanding of how to treat a low or high glucose, can count carbs, and can give their own injection or bolus on an insulin pump. However, there is a spectrum, and each child masters these skills at a different rate. And that is okay.
Even if a tween has the ability to do diabetes-related care tasks independently, he or she still needs close supervision by an adult. A confident and independent 13-year-old with diabetes may be able to manage their own diabetes day-to-day without a lot of adult supervision, but they shouldn’t have to. This is a huge burden and can often contribute to diabetes burnout.
Puberty makes blood glucose management more difficult, even if the tween and the parents are doing everything “correctly.”
Hormonal changes that are causing rapid growth and pubertal changes also cause insulin resistance, which results in higher insulin requirements. Emotional changes that come with puberty and more complicated peer relationships can also affect glucose levels. Insulin doses may need to be adjusted frequently; call your diabetes team for guidance if needed. Tweens, especially girls, who go through puberty and have their growth spurts earlier than boys, can sometimes need insulin dose adjustments every couple of weeks. Therefore, even if your tween is fairly independent with their diabetes care, stay involved enough that you know when glucose levels are heading out of range and adjustments are necessary.
Time spent with the certified diabetes educator should be focused on transferring the diabetes knowledge from you to your child. The education should be more focused on the tween so that they gradually are learning everything that you learned over the preceding years.