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Feb. 23, 2022

#59 TEEN SERIES Part 7: T1D Teens and Driving with Moira McCarthy

#59 TEEN SERIES Part 7: T1D Teens and Driving with Moira McCarthy
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I'm back today with Moira McCarthy, fellow type 1 mama and author of the bookRaising Teens with Diabetes: a Survival Guide for Parents. This episode was inspired by one of the chapter's in her book and is all about driving. What do teens with type 1 diabetes need to know before they get behind the wheel of a car to be ready to tackle the road responsibly? Find out in today's episode! Plus, some tips and tricks to keep them safe and their parents sane while learning how to drive.

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#59 TEEN SERIES Part 7: Teens and Driving with Moira McCarthy


Katie: Hey fellow diabetes parents. This is episode 59 of the sugar mamas podcast and the seventh episode in the series for parents of T1D teens. Today, we are discussing a rather hot topic, teens with diabetes and driving. I'm back with Moira McCarthy, author of the book, raising teens with diabetes, a survival guide for parents.

Katie: If you've been with us since the beginning of the teen series, you'll know that Moira. The first guest in the series, which was episode 53. If you want to go back and take a listen, this is a very short and sweet episode. So there won't be any product feature or anything like that. We're just going to go straight through, but it is packed with a lots of great information to get those T1D teens ready to tackle the road responsibly. You're listening to the sugar mamas podcast, a show designed for moms and caregivers of type one diabetics [00:01:00] here. You'll find a community of like-minded people who are striving daily to keep their kids safe, happy, and healthy in the ever-changing world of type one. I'm your host and fellow T1D mom, Katie Roseboroughugh.

Katie: Before we get started. I need you to know that nothing you hear on the sugar mamas podcast should be considered medical advice. Please be safe, be smart, and always consult your physician before making changes to the way you manage type one diabetes. Thanks. 

Katie: All right, everybody. I am back with Moira McCarthy today. And today we are going to be talking specifically about driving. So. teens with T1D and driving, there's a whole chapter in Moira's book, raising teens with diabetes, a survival guide for parents on driving and. When I reached out to my listeners and said, what do you guys want to hear more about?

Katie: Know about the vast majority said teens in [00:02:00] general. And then several parents said driving. So we're going to talk about driving today. In the, in the book, Moira, you say that driving for any teen is a privilege and not a right. So can you explain that for us?

Moira: So. voting in an election as an American, as a right driving a car is not a right. You have to go through training, you have to earn a license. , there are reasons they take your license away from you. , and so in that way, It's a privilege, not a right. And so when you get behind the wheel of a big metal thing and projected through the world at fast speeds, you have a responsibility for all the other people out there in the world.

Moira: And so you need to do the right thing anytime you're behind the wheel of a car. , and if you don't, then you shouldn't be behind the wheel of a car. So that's what I mean by that. And I mean that in every way, not just diabetes, but diabetes too.

Katie: absolutely. , gosh, can you imagine if we didn't make him do anything and we just let them go out and [00:03:00] drive cars that way and they didn't have to earn it. That would be terrifying. I'm terrified enough with the laws that are already in place. So I can't even imagine. Let's talk about getting prepared in terms of , knowing different laws and paperwork that they might need to fill out.

Katie: What does a T1D teen need to do kind of above and beyond any other team that's going to get their driver's license, what they need, do they need to know and do to get prepared to drive? 

Moira: Well, let's go backwards first. And I want to say that because I have an older daughter who's four and a half years older than my daughter with diabetes. I had been through getting a kid to start driving, and I think that a silver lining. Of having a child with diabetes is that you pay much more attention to the details of something like this.

Moira: Because when I started thinking about the things that my daughter with diabetes needed to learn and know to drive safely, I realized that there were some things that my daughter, without diabetes needed to know that maybe I hadn't touched on as well as I could have. So I felt like if. [00:04:00] First child had been the one with diabetes.

Moira: I would have done a better job with both of them learning to drive. So that's just a little bonus. So first of all, as far as paperwork goes, every state has different rules. It's really frustrating. It's too bad. It's not across the board in Massachusetts where we live and where my daughter got her license first, you don't have to do anything.

Moira: There's no difference between you and another person with diabetes in Washington, DC, where she lives. Now, she doesn't own a car, but she got her license so that she could vote there, you know? Her license was going to expire here she had to go in front of a medical review board and answer questions about her diabetes.

Moira: So that's how varied it can be. So the first thing you have to find out is that now I am a strong believer and this is backed by Dr. Barbara Anderson, who was the psychological medical reviewer of my book and is considered, she's retired now, but one of the most respected diabetes psychologists in the world.

Moira: A1C is not a reason to let a kid drive or not drive. And that's because let's compare it to [00:05:00] drinking and driving. You shouldn't drink and drive. Right. But if you drink some time, That doesn't mean you shouldn't drive. So if your A1C is not that great, as long as your blood sugar is within, you know, not too low when you're driving, I think you should be able to drive.

Moira: And so she backed that up without I thought it in my head. And then she said you shouldn't use A1C as a reason. So, so I personally don't believe in that. I know there are states where you have to have an endocrinologist. To get your license and some of those endocrinologists base it on the A1C. Um, I'm not sure what you can do about that, except maybe talk to them.

Moira: But that's it, that's it for paperwork it's, it's different in every state? , I believe there was a list in my book, but my book was written in 2013. So I would suggest people go to good old Google and look up what the rules are in their state. And then you figure out what you need for it. But like I said, Massachusetts, nothing, Washington DC in front of a medical review board.

Moira: That's so [00:06:00] crazy. It is right.

Katie: that's insane. Did Lauren share with you any of the questions that they asked her? Like what kind of things were they asking her? 

Moira: you know, like about how she cares for herself. She said it, it was pretty obvious that none of them knew much about diabetes. I remember that. And it was, she found it annoying because everyone with diabetes finds it annoying when other people try to ask them questions, you know, plus she had already had her license for years, but, you know, and things like, what do you do? How do you feel when you feel bad? What do you do about it? And she had to answer. It's just silly, but you gotta do what you gotta do, I guess. 

Katie: Yeah, sure, man. that's crazy. I haven't looked into it. , yet for, I mean, I, my oldest is only 11, so I'm just gonna , live. in ignorant bliss for right now. So I haven't looked at it into it for our state. I mean, if I Can base, if I can guesstimate what it would be based on everything else that the state of Florida does, they probably don't care.

Moira: Can I change by then? You know, 

Moira: so 

Katie: Yeah, that's very true, but I feel like Florida traditionally is pretty laid back, but we'll see. I will find out soon [00:07:00] enough. so let's talk about general guidelines for just safety while driving, you know, just how, what are, what's your best advice for making sure that teens with T1 D are as safe as possible while they're driving? 

Moira: above and beyond all the other things that everybody else should do, they have to know what their blood sugar is. And for my daughter, we did not have a level. we did have a low limit where she had to check before she got in the car. We'll talk about CGMs and that a little bit too, but she had to check before she got in the car.

Moira: And if she was lower than a certain amount, she shouldn't drive. If she was just driving to the convenience store and back, she didn't need to check again. But if she was driving to a friend's house for an hour or two, then she would need to check again. We had a time between things. , the reason we didn't have a high limit for her is, , When she gets high enough that she feels awful.

Moira: She's not, she doesn't want to go anywhere anyway. And she can function perfectly well, a little bit high, you know, you know what your [00:08:00] limitations are, but she used to say, gosh, mom, if, if I could only drive a car between. 80 and one 60, I would never be able to go anywhere, , so we did have an in, she worked with her endocrinologist to figure that out, and that was a hard and fast rule.

Moira: We're going to talk about contracts, but we had it in our contract and sure enough, the first week she could drive that I was so happy that I didn't have to drive her anywhere anymore. She didn't do what she had to do. And I had to take away the keys for. A period of time. And it was like, I don't want to drive her again, you know, and maybe I should have punished her and not driver, but I didn't, I drove her places.

Katie: I feel like that is the hardest part of being a parent is putting out these boundaries and these consequences. And then when they actually don't do what they're supposed to do following through, and you're like, dang it. 

Moira: Right. Why did that make it? So it punishes me to dagnabbit, some of the other things that I realized that she needed to learn, that I would've liked to tell my other daughter is, first of all, how and where to pull [00:09:00] over safely. Like if you start to feel low and you're on the highway and everyone's going 70, don't pull over in the median.

Moira: Do you know what I mean? And how to get to an exit? And if it's dark, how to, how to get closest to a place that you're safe. And so what we did is we did load. Oh, before she even had her permit, we would be in the car and I would say, okay, you feel low right now. You look around and tell me where we should go and where we should pull off and what we should do.

Moira: And she would look and say, okay, that, you know, there's a rest, stop a quarter of a mile. According to that sign, I know it can get there or the next exit. Shopping Plaza at the end or there's a, you know what I mean? And so we practiced it and we actually did it so that she got in the habit of it. And I realized that I don't think I ever taught my older daughter that, you know, I never thought because things happen in cars that you need to pull over.

Moira: And then the other one is, , to, , not when you feel low, don't take care of any of that while you're driving. There were not CGMs as much. When I wrote the book, there certainly was [00:10:00] not share. And I would say now I would tell my children to put their phone and their CGM receiver if they use one or just their phone, if they use that in a bag in the backseat of the car, with the sound on.

Moira: So then if they hear an alarm. They can pull over safely as they've learned to and look at it there because you know, texting, looking at a CGM on your phone is really not that much different than texting. And for all of us, it only takes one glance down to have something terrible happen and for teenagers even more so.

Moira: So I, I love the idea that they can always know what their blood sugar is when they're driving. But I think if you have them put it in the backseat and they won't be tempted to look at it and they'll know they have. 

Moira: To get it. And then if you see it on your share, you shouldn't really text them because that's just more, you know what I mean?

Moira: I think that's a big safety thing. So I would suggest that, some of the other things were, , not being afraid. If [00:11:00] they make a mistake, in something and just pulling over the car and calling your parents and saying, you need to cover. You're not going to get in trouble. We'd rather figure out how to get the car home.

Moira: If you know, if you're really low and you can't get up or you're hot, you're so high that you feel terrible or whatever. No. 

Katie: Yeah. 

Moira: things with friends in the car were more general than diabetes related. I think those were the main, the main diabetes things always have, glucose tablets in the car or whatever it is you use.

Moira: I found glucose tablets work best in the car. My daughter doesn't mind them. They just kind of sit there forever and it's not like a juice box, so it's going to burst in the breeze or something like that. so always, always have easily accessible. that, what else worries you about driving? Oh,

Katie: Oh, everything. . I mean, honestly, I've already told my husband, like I said, I don't have a kid who's getting ready to be driving in the next year or two, but I've already told him, like you were, you're going to have to do it. I mean, I can be the. Educational piece of it, , kind of helping them get what they need to get in terms of paperwork and, [00:12:00] and knowing the laws and stuff like that.

Katie: But, you know, I'm the wife that like my husband's driving and I'm, you know, I'm like in which I'm not, I'm not really that I feel like that doesn't really fit with my personality. Cause I'm pretty laid back and I don't worry a whole lot, but in the car sometimes I just have to close my eyes because he, you know, he's like, you've got to stop.

Katie: Like I know I'm sorry. 

Moira: A lot of my friends and I would switch to. For practice driving because you have a different reaction with someone else's kid than you do with your own kids. So when they have to get the driving hours in, like, I'd go with my friend's kid and my friend would go with my kid cause we wouldn't get as upset.

Katie: I was going to say earlier, when you're talking about having the phone in the backseat of the car and this, this might be the lesser of two evils, but I know like a lot of, I wear a smartwatch that has my daughter's number on it. And I know a lot of teens probably might have a smart watch too.

Katie: So that would probably be helpful. You know, you have your hands up on the steering wheel and you can just see what it is. Yeah. On your wrist. Of course you still are having to glance away from the road, so 

Moira: No, but at least right [00:13:00] there. And you can look quick. You know, might be a good solution.

Katie: yeah, yeah. Something, something to think about. I know in Florida you were just talking about low snacks too, like Florida.

Katie: I mean, this is a no brainer, but you can't have anything that's gonna melt. Cause it'll be a puddle. 

Moira: Yeah. So group has, has N so, uh, as far as lows go, it's really important for kids to know before they even start driving that if they ever are in an accident because of their blood sugar. It's their responsibility and they're liable. There's no, there's no pho 5 0 4 for driving. In other words, you, if you are low or your what's going on in your diabetes causes an accident, you are going to be held responsible for it.

Moira: And it's important that they understand that.

Katie: Yeah, that it's just a serious. Drink alcohol, , and got behind the wheel impaired. Is there a name for that? We're driving wall medically impaired or maybe not, but it's, it's basically the same thing in your mind is [00:14:00] what you're saying? That they're just equally as dangerous. 

Moira: Right. Like I've had parents say to me, well, he got charged with driving to in danger, but it's not fair because he was low. He was driving. He was driving when he was low. So he was driving to endanger. And, and if you know that, then you maybe we'll be a little more careful, you know, that there's no, even if it's not your fault that you go low it's pretty unusual.

Moira: I know some people do, but it's pretty unusual to have lows that come so quickly that. Take any action. And so hopefully most kids feel it coming on. Know something's getting, you know, aren't being distracted by their friends and, or say to their friends quick can be some glucose tabs. That's the other thing too.

Moira: I would tell my kids driving when in doubt. Eat something. So let's say you start to feel low and you look on your watch or you pull over and you look and your, it says like 1 92, and you're like, oh, that's weird. I'm not low. I would say when driving, just treat the low. If you feel that way, if [00:15:00] you're high and you go higher, you can fix it later.

Moira: Better, better than risk.

Katie: Absolutely. Yeah, I think that's great advice. So let's talk about driver's ed, because a lot of teens these days take driver's ed. I mean, I took a driver's ed course when I was a teen and I feel like that's even more common nowadays than it, than it was when I was growing up. 

Moira: State and the parents have to take driver ed to in Massachusetts. 

Katie: No with their team. 

Moira: Nope. You take a separate class. You have to go to driver ed. Only one. Your first child gets their license

Katie: how long has it? 

Moira: Like three, two hour lessons. It's ridiculous. 

Katie: Oh my 

Katie: gosh. That's crazy. I mean, some people might need it. Let's be honest, okay. So, but driver's ed. So how do you recommend that they approach, you know, just approach their diabetes with their driver's ed instructor? Because I feel like it needs to be mentioned, but maybe not made a huge deal of what what's your advice on that?

Moira: So my advice would be for the child to approach the driver and instructor [00:16:00] themself and say, I just want to let you know when we're driving, I have type one diabetes and here is a list of here's the contract that my parents and I are going to sign together for me driving. Just so you know, I'd like to follow these rules while you're teaching me.


Moira: . And I think that just letting them know and also telling them I'm very confident in my care. I promise you it's going to be okay. But just so you know, these things.

Moira: So if I say I need to pull up. And you may win. You may, should. They may want to ask the driver, right. Instructor to throw in a couple of fake, low moments, you know, look for where you're going to pull over to figure out how you're going to treat things like that.

Katie: Yeah, that's good advice. But you recommend that they, the kid take the lead on that. like you don't need to be the one bringing that.

Katie: up to the driver's ed instructor. 

Moira: I mean, it's a good age for them to begin speaking for themselves and advocating for themselves and driving is a very grownup responsibility. So if you don't feel grown up enough to talk to your driver ed instructor about your diabetes, then maybe you're not [00:17:00] grown up enough to drive, you know,

Katie: Yeah, that's very true. Well, you've mentioned it a couple times about the driving contract and in your book, you make it very clear that you think that the rules that you and your kids are gonna follow. And the boundaries that are set should be written down on paper as if any contract in signed by both parties.

Katie: So just tell us a little bit about the contract. What do you recommend people have in it? 

Moira: Well, I would have everything from an, I think there's an example in my book. And if you Google. I'm a wine. I think you can find my contract online too. If you don't want to buy the book, everything from you must wear a seatbelt to a number of friends you can have in the car at a time to making sure there's gas in the car and not letting it run to empty too.

Moira: if you get a speeding ticket, what we're going to do. Too. You must know what your blood sugar is before you get behind the wheel of the car. And the thing that I would add to it is [00:18:00] not having your phone up in the front of the car with you, have your phone. Someplace else, you know, where you can't make access, can't have access to it because our kids are particularly, particularly ones on CGMs are particularly attached to their phones and all kids are too, but I would have that.

Moira: And then of course the things like, you know, if you drink and drive, you will lose the right to drive for a very long time and things like that. we agreed to the contract, we sat down and we read. Together. And we came, we brainstormed on it and we agreed on everything and we signed it together so that it was cast in stone.

Moira: And the reason that I do that did that, and I didn't do it with going to slumber parties or going to the school field trip. Is that again, other people's lives are at risk when you drive a car until you have more responsibility than anything else. And it makes it real. It takes away the gray area. So they can't say, well, I knew blah, blah, blah.

Moira: It's here on the contract on you agreed to [00:19:00] it. You signed it. Give me the keys. You're not driving for two weeks. So whenever,

Katie: yeah, I I'm, I'm definitely going to do this with my first child that does not have diabetes, you know?

Moira: I wish I I'm telling you. I would have done such a better job with my first daughter if I had gone through the D because we, we worry about so much more. Not that we don't worry anyway, that it just made me think of a lot more things, you know?

Katie: Yeah, I didn't. Did you come up with the contract ID on your own or had somebody recommended that to you? I think it's a great idea.

Moira: I absolutely don't remember. I apologize. 

Moira: it's probably a combination, probably a bunch of moms were sitting around talking and we were like, let's make contracts, you know, so 

Katie: that sounds like a great idea. All the kids are like, no. Well, anything else? Is there anything else about driving specifically that we didn't touch on that you can think of? 

Moira: no, I just think that, it's just another step where parents have to step past their fear. I mean, the first time my older daughter drove out of the driveway in the car with her younger [00:20:00] sister in the car, she didn't even have diabetes. And my husband like went out and followed them like two cars behind all day.

Moira: It's scary. So work, work through your fear, figure out reasonable numbers to make them stop at you. They know by now, unless they're newly diagnosed, you might need help with the doctor figuring out, but they know where they should be before. They're really low to stop. You know, they like my daughter would say she knows what number she should.

Moira: So just let them have input. Make smart choices. Practice practice, practice, and then cross your fingers and send them off.

Katie: again. Great advice. Well, thank you so much for coming on today , thank you for taking time out of your day to talk with me. I've I've just really enjoyed it. You, I feel like you're just a wealth of knowledge and wisdom, and I appreciate it. 

Moira: It's my pleasure and I love what you're doing for people out there. It's good for us older parents to see a new generation, helping share information and start discussions and support one another. So thanks for what you're doing.

Katie: Well, thank [00:21:00] you. Thank you. Hey, I hope to see you at that. , what are they? What's the official name of the JDRF ride. 

Moira: It is the JDRF ride to cure diabetes. 

Katie: Well, one day with my beach cruiser, I'll pull up with my beach cruiser. 

Moira: And then we'll do another podcast about it.

Katie: Yes, that would be awesome. I know, I definitely want to do an episode about the walk after next year when it's over, 

Moira: Good for you. Alright. 

Katie: Moira. Thank you. Have a great day.

Moira: Have a good day. 

Katie: Okay, that is it for our show today. Be sure to check out the show notes where you can find more information on where to grab a copy of Moira's book for yourself. And if you're the parent of a T1 D teen or a kid living with diabetes, who will one day be a teen, you're definitely going to want a copy of her book.

Katie: Also be sure to go back and listen to episode 53, to hear my first interview with Moira. It's one of my. If you're looking for a no strings attached way to support the podcast, because you're just an awesome person, then head on over to buy me a coffee.com forward slash SugarMomma. Every single [00:22:00] donation given we'll go to making this podcast get from my mouth to your ears each and every week.

Katie: And if you choose to do that, thank you in advance. As always my friends stay calm and bolus on by.

Moira McCarthyProfile Photo

Moira McCarthy

Moira McCarthy

Moira McCarthy was working toward her goal of being a world-class ski and adventure writer when her then six year old daughter Lauren was diagnosed with T1d in 1997.

Since then, Moira has served in lead International roles in diabetes advocacy: President of the New England JDRF, JDRF International Board Communications, Outreach and Development groups, National Chair of Advocacy for JDRF, ChairMom of Children's Congress, and was named JDRF International Volunteer of the Year.

She has also served as President of the Diabetes Scholars Foundation, on the board of DECA, on the board of The Barton Center for Diabetes Education and on the board of Insulin For Life, now one of the lead groups helping with diabetes disaster assistance. She is well known for her famed Gala gown worn in 2016 as a tribute to PWD.

Moira is the author of the blog "Despite Diabetes," as well as three books on raising kids with diabetes, including The Everything Parents Guide to Diabetes and Raising Teens With Diabetes: A Survival Guide for Parents, which was named a top book by The Lancet, considered the most prestigious medical publication.

Lauren, now nearly 25 years into live with T1d, is thriving despite some tough years, and works as director of Patient For Affordable Drugs in Washington DC, leading the fight for affordable insulin for all.

Moira, who thought on that day in 1997 that her career dream was over, won the Harold Hirsch Award for Ski and Outdoor writing in 2019- naming her the top ski and adventure writer in North America. Despite diabetes.