Why a Framework Matters

When your child has T1D, you quickly realize that everyone around them needs some level of understanding — but not everyone needs the same depth. Your child's soccer coach doesn't need to know how to calculate insulin doses, and your child's teacher doesn't need to understand pump site rotations. Trying to teach everyone everything leads to overwhelmed caregivers who remember nothing.

That's where the 3-Level Communication Framework comes in. It gives you a structured way to decide what to share with whom, so that every person in your child's life has exactly the right amount of knowledge to keep them safe.

Level 1: Basic Awareness

Who it's for: Casual contacts — birthday party parents, sports coaches, after-school activity leaders, neighbors, babysitters for short periods.

What they need to know:

• Your child has Type 1 Diabetes (it's autoimmune, not caused by diet)
• Your child may need to eat snacks at specific times — this is medical, not a preference
• If your child seems confused, shaky, or unusually tired, they should call you immediately
• Where the emergency kit is and your phone number

What you provide:

• A one-page info card with your phone number, basic low symptoms, and "when in doubt, call me"
• A small bag with juice boxes and glucose tabs labeled with your child's name

Level 2: Active Supervision

Who it's for: Regular caregivers who spend significant time with your child — teachers, daycare providers, school nurses, regular babysitters, close family friends.

What they need to know (everything in Level 1, plus):

• How to read the CGM (or what blood sugar numbers mean)
• When to give a snack and what kind
• How to treat a low: the 15-15 rule (15g fast sugar, wait 15 min, recheck)
• When to call you vs. when to handle it themselves
• Basic understanding of highs and what to watch for
• How to supervise your child during meals (portion awareness)

What you provide:

• A 2-page reference guide with clear decision trees
• Access to the CGM app (Dexcom Follow, LibreLink, etc.)
• Pre-packed snack options with carb counts labeled
• A clear "call parent" threshold (e.g., below 70 or above 300)

Level 3: Full Management

Who it's for: People who will be fully responsible for your child for extended periods — grandparents during sleepovers, the other parent in shared custody, a nanny, the school nurse who administers insulin.

What they need to know (everything in Levels 1 and 2, plus):

• How to count carbs for common meals
• How to deliver insulin (pen injection or pump bolus)
• How to adjust for physical activity
• How to handle a severe low (glucagon administration)
• Sick day rules (when to check ketones, when to call the doctor)
• Nighttime management basics

What you provide:

• Hands-on training sessions (see Part 3 for the 4-step method)
• Written protocols for meals, bedtime, and emergencies
• Glucagon training (practice with an expired or trainer kit)
• Direct line to your endocrinologist for emergencies

Scenario: Sophie's Birthday Party

Lena, mom of 6-year-old Sophie (diagnosed at age 4), was dropping Sophie off at her friend Maya's birthday party. Maya's mom, Charlotte, had never looked after a child with T1D before.

Lena used Level 1 communication. She handed Charlotte a laminated card:

Sophie has Type 1 Diabetes.

• She can eat everything the other kids eat (I've already given her insulin for the cake).
• If she seems shaky, confused, or says she feels "funny," give her this juice box and call me.
• My number: 555-0123. I'm 10 minutes away.

Charlotte felt relieved — the card was simple and clear. She didn't need to understand insulin or carbs. She just needed to know when to worry and what to do first.

Why this worked: Lena matched the communication level to the situation. Charlotte needed awareness, not expertise. Overloading her with pump instructions would have created anxiety, not safety.

Quick Reference: Who Gets What Level?