When her 9-year-old daughter Addison came home from her first slumber party, “she was so excited,” explains Sarah Paul, of Germantown, Wisconsin. “She finally got to be with her friends at someone else’s house. She knew it was a big step.”
Addison has lived with type 1 diabetes (T1D) since age 2 and a half. She has worn life-saving technology to give her insulin and monitor fluctuating blood glucose levels since age 3. But she had never been to a sleepover.
Children with type 1 diabetes don’t produce insulin, a hormone that converts food into energy. Without insulin—or enough insulin—food is converted into glucose (or sugar), but the body can’t use it. Excess glucose can cause diabetic ketoacidosis. Low blood glucose can cause confusion, sweating, shakiness, loss of consciousness, and seizures. Both ends of the spectrum can be dangerous, even fatal, and need immediate treatment—sometimes even a trip to the hospital for regulation.
For a safe slumber party, the child and the hosting parents need to know how to monitor blood sugar levels and how to treat high or lows accordingly. It can be scary for parents of kids with childhood diabetes. But, there is always a way to make things work so kids with juvenile diabetes can participate in sleepovers, camps, or other activities that involve staying elsewhere overnight independently.
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How to prepare for a sleepover with juvenile diabetes
Just like every other aspect of living with childhood diabetes, preparation for an overnight stay is key. “Every family is different, but if you would have said yes to a sleepover without diabetes, then you work to say yes to it with diabetes,” says Diane Herbert, a certified diabetes educator and principal of E1c Matters, a diabetes consulting and advocacy firm based in Philadelphia.
What’s the best way to prepare? Diabetes experts—and parents who have been through it—shared these steps.
Host a slumber party, or start with a “sleep-under.”
“Some parents do sleep-unders,” Herbert recommends. This is where the child stays at the friend’s house late, changes into pajamas, but goes home before actually going to bed. “Doing a sleepover largely depends on the age of the child,” she says.
Before her first stay at a friend’s house, Sarah’s daughter Addison had been allowed to have friends sleep at her house—but she couldn’t stay at their houses until she knew how to test her own blood sugar levels and how to treat high or low levels accordingly.
Do a test run to build independence before the overnight stay.
If your kid manages his or her own juvenile diabetes, by self-testing blood glucose levels, making insulin dosing decisions based on what is eaten, and/or changing out the insulin pump components independently, it’s time to test it at home at night.
“Pick the day of the event, back off by a month or so, and get everybody ready and comfortable,” Herbert says. “Build the skills over time. The time to learn it is not the day of the sleepover.”
Talk to the host parents about T1D responsibilities.
Addison’s mother wanted to feel comfortable about the hosting parents’ understanding of the responsibility involved with juvenile diabetes. “Her friend’s mother contacted me and asked if Addison could come over and we had a discussion from there,” Sarah says. “She knew nothing about diabetes, and I went to her house and showed her the devices Addison uses. The mother got a quick lowdown of how they worked, had extra juice on hand, and said she would keep her phone on all night in case I needed to contact her.”
“At a minimum, the parents of the children with diabetes should write out an emergency plan for the host parents,” says Anastasia Albanese-O’Neil, a certified diabetes educator and a clinical assistant professor and the director of diabetes education and clinic operations at the University of Florida.
Write a list of what to do in certain scenarios.
“It should include how to check for and treat severe low blood glucose, symptoms of ketones [which appear in urine or blood when levels are high] and the names and phone numbers of who to contact for help,” says Albanese-O’Neil.
Pack everything your child will need to successfully self-manage their condition.
This can include:
- Syringes and insulin if your child takes shots
- An insulin pump and a change of supplies if the pump might need to be changed while at the sleepover
- A glucose meter with extra batteries
- Test strips
- Lancets and alcohol swabs
- A source of fast-acting sugar such as a few juice boxes or a container of glucose tabs
- A continuous glucose monitor if your child uses one
- A charger for the insulin pump and/or continuous glucose monitor, if needed
Teach your child the lingo.
Addison uses a continuous glucose monitor (CGM) that remotely senses glucose changes, and an insulin pump that delivers a bit of insulin all day long and also lets the user take extra insulin before meals without an injection each time.
For a child who doesn’t use a CGM or injects insulin instead of using an insulin pump, the child needs to test blood glucose levels regularly and act accordingly, or work with the host parent to do so.
Albanese-O’Neil advises preparing your child to talk with friends and their parents about their condition. “Give them some language to talk about their diabetes so they feel comfortable and confident,” she says.
Encourage your child to stay in touch.
“If a child is able, on a pump, they can test and then correct a high, or call home and follow a parent’s instructions to treat a high with a certain amount of insulin,” says Gary Scheiner, a certified diabetes educator and the owner and clinical director of Integrated Diabetes Services of Wynnewood, Pennsylvania.
Even if kids are old enough to handle their diabetes on their own, it never hurts to double-check a dose with mom and dad, or confirm they are doing the right thing. Let them know it’s okay to text or call for reassurance and help—no matter what time of night.
Learn to let go, a little.
That first night, relying on the diabetes technology she has worn for the past six years, Sarah watched Addison’s blood glucose levels through a smartphone app. Because Sarah is used to monitoring Addison at home—through the night with regular wake-ups to double check glucose levels (the CGM needs to be calibrated with finger sticks)—it was hard to watch from afar. “I didn’t get any sleep on my end, but she has felt more independent,” Sarah says. “We try to let her be a kid and have as much normalcy as she can.”
Expect some irregularities.
Because of different foods and activities with overnight stays, Scheiner says you shouldn’t be alarmed by some of the changes. “Don’t expect the usual blood sugars with these types of events, as they can rise or fall if the child is chasing others around the house at midnight or eating Doritos out of the giant bag,” he says. “You don’t have to have beautiful blood sugar control in these cases. Don’t panic if your child [has blood sugar readings] in the 200s in situations like these.”
Diabetes shouldn’t rob your kid of typical age-appropriate experiences. “Sleepovers are a special ritual of childhood and children with diabetes should take part in them whenever possible,” Albanese-O’Neil says. “While it will require extra planning and the need to educate the host family, the reward of lifelong memories is worth the effort.”