Providing age appropriate explanations to a child is an integral part of the work of a child life specialist and crucial to healthy coping for the patient. Following is one way of explaining type 1 diabetes that could be used for older children. In addtion to the words used, any visuals and props, like a toy school bus and kid figures, can help further deepen the understanding for the child and allow the child to play out the situation.
"Every time you eat something, sugar is released into your body. The sugar, which is also known as glucose, helps the food you eat get into your cells to give your body energy. But the sugar can’t do its job alone. It needs help from something called insulin. Insulin is a hormone made by cells in the pancreas called beta cells. The insulin is like a key that unlocks the doors of our cells to let the glucose in to where it needs to go in your body.
In people who have diabetes the insulin cannot be made by the pancreas. The reason why is that the body sees the beta cells as “foreign” and not supposed to be in the body and it gets rids of them. Without the “key” to get in the cell door, the glucose gets built up with nowhere to go and it becomes overwhelming for the body and makes you sick.
Imagine this: You get on the school bus in the morning and it takes you to school.
You and all the other students get off the bus and go into the school and down the hallway to get to your classroom. The problem is, the principal couldn’t get to the school so there was no one to unlock the classroom doors. But all the buses are coming and all the kids are still getting off the bus and coming into the school. The hallways are filling up with people and it’s getting crowded because none of the classroom doors are unlocked and no one has anywhere to go. Now imagine that the people that are crowding the hallways are the sugar in the body, the classroom is the cell and the principal is the insulin. The good news is that there is a way you can help your body do its job. The way you do that is to give it insulin from outside the body by injecting it yourself and this will help the glucose get into the cells to give you the energy you need."
Diabetes management is, of course, a whole different explanation and this was written with the objective being to help a child with the initial understanding of the diagnosis in ways that are developmentally appropriate. I would love to hear what creative ways you have come up with to explain a new diagnosis to a patient. Please feel free to email me and I will include you in a follow up reader's response post!