Growing Up: Handing Over Care

A child diagnosed at six has their diabetes managed for them. An adult with Type 1 manages it alone. The handover between those two states takes years and is rarely smooth.

A workable sequence looks roughly like this. Young children learn what a low feels like and to tell an adult immediately. Older children learn to test themselves and to read the number. Early teenagers learn to count carbohydrate and calculate a dose with supervision. Later teenagers take over day-to-day management, with parents moving to review rather than control.

What goes wrong is usually one of two things.

Handing over too fast leaves a young teenager managing a condition with real consequences while also managing school and everything else. Control often slips, and the slip gets read as defiance rather than as too much responsibility too early.

Handing over too slowly is the more common problem in practice. A seventeen-year-old whose parent still does all the dosing arrives at hostel or college genuinely unable to manage alone.

Adolescence complicates this biologically as well — insulin needs rise through puberty, so doses change repeatedly during exactly the years when responsibility is shifting.

The other transition to plan for is moving from paediatric to adult diabetes services, which is a known point at which young people drop out of care.