5 Steps for Leaving Your Type 1 Child with a Caregiver

“What is your blood sugar?”

“200.”

“Do you have any active insulin?”

“No.”

“Then please give yourself a correction.” 

Would your caregiver be able to have this conversation with your Type 1 child? While technology advances have made it possible for you to track your child’s CGM even when you are not there, it is not a substitute for a well-trained caregiver. While it may seem a daunting task to find someone who you trust leaving your T1 child with, it is possible! Here are 5 steps to help you have a great experience with your caregiver. 

Step 1: Know where to look 

If you want to try to find a sitter who either has Type 1 or lives with a family member who has Type 1, ask your local support group or your endo for suggestions or use a website like safesitters.org. If you find or already have a great caregiver who doesn’t have any experience with Type 1, it is possible to teach them how to care for your Type 1 child. Make sure your sitter knows the basics of Type 1, blood sugar management tools, how insulin works, why your child will have highs and lows even with good management, carb counting and how different foods/activities will affect blood sugar. Share resources you found helpful when you were learning about Type 1 management. 

Step 2: Write out a care plan 

Even if your caregiver is familiar with Type 1, each diabetic has different management styles and it’s important to teach your caregiver how you manage your child’s Type 1. They also might not be familiar with the specific brand of pump/CGM/MDI you use. What your child is able to do on their own will also be unique. Can your child test their own blood sugar and give a bolus? Can your child calculate carbs? Can your child set a temporary basal (and know when to), extended bolus or give a correction? Even if your child can do many of these things on their own, your caregiver will need to know how to do these things too and the amount of appropriate supervision your child will need with these common tasks. Your caregiver will also need to know the ideal target range for your child and when action is needed. Do you give a snack when blood sugar is under 100 or under 80? Do you give a correction when blood sugar is over 150 or over 180? Also, explain how you use the up or down arrows on the CGM and how they might alter your treatment plan. If needed, also have clear instructions on how to handle bathing/swimming. 

Step 3: Signs to look for 

It is important to teach your caregiver the signs of both high and low blood sugar, especially the common symptoms you notice in your child. If your child is acting out or having a tantrum, it might be typical childhood behavior or it could be low blood sugar. If your child is guzzling water, they might just be thirsty or might have high blood sugar. Also, make sure your caregiver knows when a situation is serious and they need to call 

for help. Many caregivers are reluctant to ask for help if they don’t know if it’s serious enough. It is also important that your caregiver is trained in first aid and CPR. 

Step 4: Set up good communication 

Make sure that as much as possible, your or your spouse is available if your caregiver has questions. Even the best-trained caregiver might encounter a situation and aren’t completely sure how you would like them to handle it. Be careful with letting your caregiver have access to your child’s CGM data directly to their personal phone. This is medical data that you are sharing and you want to protect your child’s privacy as much as possible. Show your caregiver how to see the CGM data on the pump or receiver and be prepared to contact the caregiver if you get an alert on your phone that needs attention. 

Step 5: Have a backup plan 

Always prepare for something to go wrong: your child pulls out their infusion set or pod, runs out of insulin (families are busy, it happens), CGM sensor fails or won’t connect. Plan ahead of time how you will handle these situations whether it is teaching your caregiver how to put on a new infusion set, how to give an insulin injection with a vial and syringe, or how often to finger prick if the CGM isn’t working. Or it could be easiest to have a family member nearby on call who can come help if any of these situations happen. Do what is most comfortable for your caregiver and your child, just make sure there is a plan in place before something happens (because it will). 

Although leaving your Type 1 child with a caregiver may never be easy, it is possible to do it safely. You and your child will both benefit from the experience no matter how hard it seems initially. Having someone you trust to care for your Type 1 child in your absence will be worth their weight in gold. 

Christina has been a Type 1 diabetic for 14 years and a caregiver for more than 20 years including several families with a Type 1 child. She loves showing off her diabetic gear and is passionate about educating non-diabetics about what life looks like living with Type 1 diabetes. You can visit her blog at www.thelazypancreas.com or follow her on Instagram @cria_T1D