There is no such thing as a perfect diabetic. How many "perfect" diabetics have had days of unexplainable high or low blood sugars? Millions. The body is too complex to explain at times. We've all had our days when we have an unexplained low and are caught off guard without having sugar. We've also all had days where we misplace or leave behind our cell phone, briefcase, favorite hat or purse. It is no different when a child simply forgets one day to take dex tabs or their meter to school. How many times have they remembered to take it?

Habitual problems are another story. The important thing is to make sure the consequences of poor diabetes choices fits the "crime" and educate the child on the correct choice. Example: when one list member’s daughter first started pumping, she missed a bolus every now and then - then after a couple of months got very complacent about doing boluses at all. So her "consequence" was that for a week, she couldn't eat snacks unless her parents "heard the beeps" - a real hassle for a kid tasting her freedom. After the consequence, she was then on her own again. It took 2 weeks (separated by a couple of weeks) before the message was truly learned, and since then, her mom doesn’t think she's ever forgotten a bolus. Yelling, or hitting, doesn't teach a lesson.

Diabetics cannot always be held accountable for their actions when having a low blood sugar. Harsh words can sting, and although it is difficult, you must remember that diabetics are not in a sound mental state when they are low. They may say or do things and have no recollection hours later. Black eyes from flailing arms are sometimes easier to forgive than words said - just try to remember though that the same mental state that caused your loved one to sock you is the same mental state that brought the harsh words. Neither would happen if the diabetic were in normal range.

As for the second part of that... diabetes is not your fault, diabetes is not your child's fault, diabetes is not a sign of imperfection... if you are uncomfortable with your child's illness (I've seen this a lot in two parent families where one parent carries more of the "load" in diabetes care), try to learn more about it. If you are that parent who carries more of the load, bring your spouse into the picture. Make it a part of her/his daily life to understand what diabetes is and how it affects you and your child's life... Please don't alienate your children over something they have no control over.

Above all, this is one of the most important things to teach your child. In simple terms, teach them food = insulin. And that if they ever are hungry or are craving sweets, please just let mom or dad know and we'll see what we can do, but never never sneak food without letting someone know.

There is no solution to this one. Akin to when women are told "You must be PMS-ing," when they are upset, this comment can only further enrage a diabetic when they are not low. Simply put though, you cannot stop asking it because 75% of the time you will be right! Just be forewarned that diabetics sometimes are a little over-sensitive to this question – and that they CAN be mad WITHOUT being low!

There comes a certain point when your child has attained those good numbers, good A1C's, and honestly does not need to be asked this question at every meal. Do you ask your thirteen year old if they brushed their teeth every night? Probably not. This one is not always straightforward. My personal advice is that if it seems your child is annoyed by this question, then strike a deal. "I won't ask as long as you let me look at your sugar sheet once a week/each night/whatever seems appropriate." Or "I won't ask that anymore as long as you tell me when you ARE out of range." Give them a little freedom... this will be the hardest thing you ever do.

If your child is seriously bothered by this, try again working a deal. Maybe you can come in at the end of the appointment to ask any questions you might have. Or maybe your child will let you phone the doctor the next day.

Independence is so vital to teenagers - try to compromise.

In the present day of carb counting, there is nothing that you cannot eat at least occasionally. This comment usually comes more from uneducated relatives, co-workers and friends. If you notice anybody saying this to your children, please educate them!

Well, obviously if you said or did any of these things to your children pre-diabetic days, it is too late. But it is NEVER too late for an apology.

I don't care if twenty years have past - please apologize!

I put these together because they both deal with a "how do you know?" type response... Don’t say it if you don’t know it for a fact. As for the "it will only hurt for a ..." line, I will admit that this line used to drive me crazy as well. But when you are trying to tackle a three year old to give another finger stick or injection, what else are you to say? Just be sensitive to the fact that as your child gets older, he/she may get overly sensitive to these types of comments. Parents that try infusions sets/prick their fingers obtain much respect from their children – "... she DOES know."

A lot of adult diabetics take the second one personally. Do you know what diabetics, especially children and newly diagnosed diabetics, are going through? Do you know what it is like to walk around as a human calculator, constantly counting minutes of exercise, grams of food, units of insulin... Do you know what it is like to live with the fears of complications looming ahead? Diabetes is an utterly complex disease that has many emotional struggles... be sensitive.

I saved one of the most important ones, in my eyes, for last. Two things – the first is that not all people with diabetes like to be referred to as A DIABETIC. It puts the disease before the person. "I am SUSAN, and I happen to have diabetes."

The second vital part to this section: there is no such word as CANNOT. A Diabetic can do ANYTHING – it might take a little more work and effort, but we CAN do it so don’t ever ever say we cannot. Please also watch for this attitude from your child’s doctor. More than one doctor has made sweeping harsh statements about having children or accomplishing athletic goals. They will say directly to a child, you CAN’T. Coming from a doctor, this attitude can be even more devastating to a child.

It is all about attitude. Attitude means never saying you can't, but rather saying, "well, you can do anything, but let's discuss it/look at it together to figure out how." Meaning if a child wants to go on a week long camping trip with friends, don't say no you can't you are diabetic. Say, awesome, it sounds cool... let's talk about how to adjust your insulin, let's meet with so and so's dad and fill him in, etc. Teach them that they CAN do anything, it might be a little more complicated, but they CAN do it - and teach them the skills to figure out how!

Now the other part of the problem... again, letting go. So let’s say your child IS on that camping trip. You’ve found a willing parent that you’ve educated, you are confident in your son’s/daughter’s ability to take care of themselves... but you still cannot sleep at night? Fact of life... write a note to the IP list, call a friend, pray. It’s not easy, but you will get through it. It’s terrifying, but it is also a part of growing up and allowing your kids to be kids. And when your child returns with a smile bigger than Texas, you’ll know that you did the right thing and you will relish the fact that they were able to just be one of the kids...