Teens and Diabetes
When children are diagnosed with diabetes, parents need to be very involved in learning about the condition, participating in the routines at an appropriate level and sharing management decisions. While it is critical that older school-age children and teens learn the details of the condition and how to care for themselves, parents must understand diabetes and its management. This parental competence promotes a safe, supportive home environment for the newly diagnosed teen and reduces stress in both parents and the child.
Learning to let go
As a child matures, the challenge for many families is finding the balance between parental monitoring and teen independence. On the one hand, careful diabetes management is vitally important to the immediate and long-term health of your child. On the other hand, you can’t be with your child 24/7. Even if you could take total control of your child’s diabetes (which you can’t), teens are more likely to rebel against tight restrictions. Rather, you may want to strive for a supporting rather than controlling role in your teen’s diabetes care. Here are some suggestions:
- Recognize how devastating diabetes can be to a teen. She wants to be carefree, and independent, just like her friends. Instead, she feels burdened with a lifelong condition and restricted by tests and injections. Help her figure out ways to fit diabetes into her schedule; share the load where you can (e.g., help her record her blood glucose results or offer to give one of her injections each day). Look for support from your diabetes team, including the social worker. Find out if your teen is interested in joining a peer support group and where this might be available.
- Be positive and non-judgemental about your teen’s diabetes management. Avoid using terms such as ‘good’ or ‘bad’ when referring to blood glucose levels. Instead, focus on helping him evaluate his blood glucose levels and determining a course of action. For example, ask, ‘Your blood glucose is higher than your target, so what do you need to do?’
- Understand, and help your teen understand, that adolescents with diabetes require more insulin as they grow and go through puberty. This is normal. It is not a sign of worsening diabetes.
- Encourage your teen to participate in sports and other activities, which are great for building self-esteem. Help her to figure out how to prevent low blood glucose (hypoglycemia), which often accompanies increased activity, by testing frequently and either reducing insulin or increasing food intake.
- Ensure that your teen understands the potentially devastating consequences that smoking, alcohol and drugs can have for people with diabetes. If you are not comfortable talking with your teen about these issues, be sure to ask your diabetes professional to raise the subject with him.
- Avoid focusing on weight and body shape in your teen. Rather, focus on promoting a healthy lifestyle for all members of the family. Some teens discover that when they are getting inadequate amounts of insulin they lose weight. Although the discovery may be accidental, some teens (particularly girls) are tempted to reduce or skip their insulin repeatedly in order to lose weight. This risky behaviour leads to poor glucose management, a risk of diabetes ketoacidosis (a life-threatening condition that arises from a serious insulin shortage) and a high risk for long-term complications. Parents who suspect this behaviour in their teen should take steps to supervise each insulin injection while they seek the advice from their diabetes team.
- Be flexible and willing to help or step back as your teen needs. Watch for signs that your teen is struggling with his diabetes management: signs of high blood glucose levels (frequent urination, extreme thirst), low blood glucose episodes (hypoglycemia), poor school attendance, depression or a significant change in behaviour. If your child shows any of these signs, re-involve yourself in your teen’s diabetes and talk to his diabetes professional for further advice.
- Keep the lines of communication open. Instead of nagging or criticizing, use open-ended questions that encourage conversation. For example, ask: ‘How do you feel you are coping with your diabetes?’, ‘What are you finding most difficult about it?’, or ‘What would help you now?’
With patience and a positive attitude, you can help your teen become a responsible, independent and healthy young adult.