It's not easy having your sibling diagnosed with diabetes. First, your parents pretty much disappear into the hospital setting with your sibling. You wait that out and worry, thinking not only of your sibling's well-being but of your place in the family. When your brother or sister comes home, you expect it all to go back to normal. But suddenly, everything has changed. What's a kid to do? More to the point, what's a parent to do?

Attention Issues

Your child with diabetes will most likely be showered with flowers, gifts, cards, and sympathy. Everyone will reach out and let her know they care. This can be tough on a sibling. Even after a child comes home from hospitalization, the gifts and attention can continue. While it's fine to let that happen, it is important to remind friends that your other children have been impacted by this disease as well.

You may want to give your other children a token of appreciation for the hardship they endured during diagnosis day. You'll also want to make sure, as time goes on, that your other children understand that diabetes does take up a lot of time and attention and that, in fact, the entire family is going to have to work toward a new normal.

That new normal may not be exactly what a sibling wants in life, and that needs to be discussed and understood early on. Sibling rivalry is natural in any family dynamic. In the case where a child gets added attention for any reason (and diabetes can be a big rea-son), parents need to point out to siblings that while added attention will go to the sibling with diabetes, it is the goal as a family not to take away attention from other siblings. A good first step toward helping a sibling understand that is acknowledging that so much attention is going to the other child. Talk about time and management issues right now (“We are still learning how to adjust insulin and may need to spend a lot of time on the phone with the doctors for a while”). Ensure that your other child will not be robbed of anything because of it. (“Of course I'll still be on the sidelines at all your tennis matches. Nothing will change that”). Point out to siblings that the simple things in life—youth sports, play dates, carpools—will not change for them; this realization will help them take a first step toward understanding where they fit into the picture.

Regression in Siblings

If you have a child who is younger than the child diagnosed with diabetes, don't be surprised to see a bit of regression. Diabetes is almost like a new baby coming into the house. It requires your attention, worry, and sleepless nights for a while. Children sense that and act out to try to grab your attention back. If you do see regression, take time to make sure you are truly giving your other child the same amount of attention you were before diabetes entered your life. It is easy for the parent or caregiver of the newly diagnosed to lose track of everything but managing the new disease. It's your responsibility not to lose track of your other children.

As time goes by, your other children are going to realize that, in fact, diabetes is not going away. While that's a big struggle for the child with diabetes to accept, it is also difficult for the siblings. It's a good idea for each parent to choose a “special event” each week with siblings: a long walk and an ice cream, or a movie date. Carve out a couple of hours each week to spend with them alone. Promise to do this and keep to it.

In the end, there is no avoiding giving your child with diabetes the lion's share of attention. But if you can back that up with a true effort to help siblings understand and still feel equally appreciated, you'll go a long way toward avoiding jealousy and anger issues.

Worries and Fears

Siblings harbor their share of worries and fears as well. Why did this happen? Will my sister die? Will it happen to me? More questions than parents can even imagine swirl through even the youngest (or most mature) minds. It is important to give each child a forum to air those fears and questions and to give them real answers.

Children will hear a lot of talk around their sibling's diagnosis and may be subject to such insensitive lines as “My great aunt lost her leg to diabetes,” or, “Too bad, if he'd just kept away from sugar.” Address these topics ahead of time. Let each child know that diabetes is a treatable disease and that the type her brother has is not the result of poor diet or bad life management. In simple terms, tell her that her brother's body stopped making insulin and you are learning how to help give it the insulin it needs. Give her response lines to store for such moments, such as “My brother has Type 1 and that is different,” or “Diabetes is easier to treat today with the new tools.”

What about the one question that comes most often and cuts to the heart of siblings: “Does it run in the family?” (See Chapter 1 for details on who gets diabetes and why.) It is crucial to tell your child from the start that while there are some rare cases where siblings also develop Type 1 diabetes, in almost all cases, they do not. Type 1 diabetes does not run in families; there is only about a 2 to 5 percent risk of carrying it over to a sibling. Your child needs to hear that from you (and it might be best to say there is a 95 percent chance they will not get the disease).

For families who want to know, there are studies that can detect whether siblings carry the antibodies for possible development of diabetes. The study, called TrialNet (www.diabetestrialnet.org), looks for three different antibodies in a child. Although it can tell you that a child may develop diabetes, it cannot tell you with all certainty that a child will or will not.

Siblings will also be afraid that your close tie to the child with diabetes means that you will love their brother or sister more. Promise them on a regular basis that you'll carve out time that is theirs and theirs alone.