Back To School: Transitioning to Self-Management


Back to school season always fills me with a bit of trepidation as I figure out all the needed supplies, buy clothes, check schedules, get updated doctor’s orders, schedule staff training and of course preparing for the 504 meeting. This year, it is proving to be more challenging than usual because I am debating whether to allow my daughter to self-manage at school.

She is 12, going into 7th grade. She currently checks her blood sugar in at the clinic when she arrives, before lunch, and when she leaves for aftercare. She can, of course, also check in the classroom whenever she wants to, which is almost never. Frankly, I set up the scheduled nurse visits to make sure she is at least checking at those times. Otherwise, she is liable to check once a day, at lunch, maybe. If I change the doctor’s orders and 504 to reflect she does not need any supervision (an all or nothing check box on the form) she will not check as much as I want, probably not always correct what I would or will correct too much and go low and her excellent grades will likely suffer until she gets it all worked out.

Despite that, I am leaning towards letting her do it, for a few reasons. First and foremost, she has always been a fiercely independent individual. She is as responsible as the average twelve- year-old, which is to say not very, but she has begged and pleaded for the opportunity to do this on her own. She doesn’t particularly enjoy the nurse visits, I think partly because she misses a lot of class and also because they sometimes say things that reveal their outdated ideas about T1D management. This frustrates her immensely and I’m sure earns them profuse exasperated eye rolls from her daily.  Oh the joy of the tween years!


She was diagnosed at four, has been checking in the classroom since pre-k, had a pump within six months, and has done her own boluses and corrections with me watching since age five. During the last few years, I just verify that she did it and text her for a number if I want one. Sometimes I even get a response! Frankly, I have to be honest and admit I am really just using the nurses to make sure she checks and boluses when I want her to. It makes me feel good and safe and that I am preventing any possible issue. Wishful thinking, I know. It does not afford her the same good feelings though. Apparently it annoys her to no end, which at twelve I realize is not necessarily difficult. Nonetheless, T1D is annoying enough that I certainly don’t need to give it any help on that front.


While risking her grades, and I hope nothing more, I feel I would be risking far more by not allowing her to give it a go on her own…deflating her budding sense of self-reliance, denying her request that we ‘trust her’ to do it (her words). I feel it is just as much my responsibility as a parent to allow her to learn the ups, downs, and hairpin turns of T1D as it is to make sure she is safe and healthy. Middle school seems a relatively safe place to make the transition. Like any parent, I am concerned her numbers will scatter, her A1C will not be great, and her grades may suffer, but honestly I am far from perfect at managing it myself. We still have lows, highs, and various unexplained BG calamities. I cannot really fault her if she experiences the same during school hours under her own management. How could I, in good conscience, hold her to a higher standard than whatever her best is on a particular day? I’m doing my best and still feel like I’m barely competent some days.

I can see it clearly in her face, despite my fears and misgivings, that it is time for me to let her try to do this. As she is sometimes fond of reminding me, I don’t have it; I don’t know what it feels like. She is right, I do not. I do however know what it feels like to sit at work and stare at my phone, willing it to send me a number and let me now she is okay. I know what it feels like to lie awake at night unable to fall back sleep unless I go check her again. I know what it feels like to worry whether she is okay every moment that she is out of my sight. Will someone help her if she needs it? Will they know what to do? Will she need me and I won’t be there?

But what if she doesn’t need me and I am there for my own reasons, inadvertently holding her back? Am I really keeping her safe by managing everything my way or am I simply delaying the inevitable and denying that she is ready and it is me, in fact, who is not?


Honestly, I think she took the D training wheels off long ago when we weren’t looking. We were more than happy to hold her and let her ride with the safety of our hand on the seat and she was content to let us do that for a time. Now she wants us to let her ride on her own… into the fog, the darkness, the rain, the crazy traffic of life with T1D. She wants to show us she can do it. I’m scared and nervous…but I’m going to let her. I know she will be able to do it. She’ll fall, get bruised and bumped, but she is just the kind of person that jumps back on and tries again. That’s all I could ever hope for – her lack of fear, her desire to take control of her own journey, finding her voice and advocating for her own independence…I couldn’t be prouder.

By Sarah Grant

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