Table 1.

Ideal division of diabetes management roles across developmental stages

Child age	Patient responsibility	Parent responsibility
Infant/Toddler (ages 0–2)	Cooperation	Total diabetes management
Preschool (ages 3–5)	Interact with parents around checking BG; cooperating with BG checks and treatment of low BGs	Total diabetes management with rare responsibility given to the child with parental supervision (e.g. selecting finger to check blood glucose level)
School-age (6–12)	Begin to understand and communicate symptoms of high and low BGs; begin to interpret BGs, start to count carbs, carry supplies	Most responsibilities with parents/adults with more responsibility given to child with parental supervision; child developing more autonomy (e.g. around eating, checking blood glucose for exercise)
Early adolescence (13–14)	Perform majority of daily diabetes tasks with supervision; check in with parents around diabetes management; begin to interact with healthcare providers on own	Parents provide more oversight than perform actual tasks; parents overseeing big picture management but share decision making with the teen
Late adolescence (15–18)	Ongoing reinforcement of self-care skills; integrating self-care with social and emotional development; routine diabetes foot care, eye exams; understanding need for future care and screening for complications	Supervision of tasks as needed; youth mostly autonomous but should feel able to seek support and help from others, especially parents