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Teens and Type 1

separator Teens and Type 1
Type 1, or “juvenile” diabetes, is most often diagnosed in children and young adults. In this type of diabetes, the pancreas produces little or no insulin. People have to learn to test their blood sugar and give themselves insulin at least three or four times per day. It’s a particularly challenging form of diabetes. And it’s frustrating, because it can be unpredictable. Sometimes, no matter how vigilant a child and parents can be, blood sugar becomes too high or too low. It’s a constant balancing act.

Being a teenager with type 1 has its own unique issues. As children become older and more independent, they gradually learn to take on more and more responsibility for their diabetes care. But when they become teenagers, they often test the limits, sometimes go into denial, sometimes rebel. This can be true whether they’ve had diabetes for years or whether they’ve just been diagnosed. It’s hard to predict how each child will be during the teen years, so parents need to be aware of what to look out for and how to do their best to keep the lines of communication open with their teens.

If you’re a teenager with diabetes, you need to know that the more your parents feel they can trust you to take care of yourself, the less likely they are to be strict and stressed out about what you’re eating, where you’re going, whether you’re testing your sugar levels, etc. 

Work with a diabetes educator
A certified diabetes educator (CDE) can help parents and kids navigate all kinds of issues that come up when a child has diabetes. After the initial diagnosis, when it’s common to feel overwhelmed, the diabetes educator can help everyone feel more confident by going over (and over and over) all the things people with diabetes need to know to care of themselves well.

CDEs can help with other difficulties too—conflicts that come between parents and children, ways to deal with food preferences, how to handle problems with siblings, how to help teenagers deal with being “different” from their friends. They are also the best ones to talk to about new diabetes products—new glucose meters that make testing easier, new types of insulin, etc. Staying in close contact with your diabetes educator is the best strategy for successful diabetes management.

For parents: what to watch for 
During the teen years especially, parents want to watch out for signs of an eating disorder and symptoms of depression. Some teenagers with diabetes learn that if they skip insulin, they can eat and not gain weight. Additionally, teenagers with diabetes are at higher risk of depression. (In general, people with diabetes are more at risk of depression than people who don’t have a chronic condition.). So if you suspect any of these kinds of issues are becoming a problem, talk to a CDE right away.

Teenagers can be infuriating because they tend to believe the bad things won’t happen to them. For teens with diabetes, the future seems a long way off, and they might not be as concerned about long-term complications as you are. With teens, it might be best to focus more on good day-to-day management rather than problems that might happen years from now.

Remember this too: our understanding of the way food affects blood sugar has changed in recent years. You may have grown up with the idea that people with diabetes can never eat sweets. In fact, there are generally no forbidden foods for people with diabetes.

Obviously, there are certain foods to limit. But try not to fall into the habit of exclaiming, “What are you eating??!!!” every time your child eats something you think may not be good for him. Instead, make sure he or she understands that eating treats is okay now and then, but that insulin has to be adjusted for those times.

Your best strategy for any of the difficulties, concerns, fears and worries you have is to talk with your CDE. 

For kids: how to gain parent’s trust
The more you show your parents they can trust you, the more they will trust you. Keep good records, and show them to your parents. If your blood sugar is too low or too high, don’t try to hide it from them by changing your records. Instead, try to talk honestly about what happened. Make sure your parents feel confident that you know what to do when your sugar is too high or too low. Let them know you understand why it’s important to keep things under control.

If you’re having problems with anything, it’s a good idea to let your parents know. First of all, they’ll feel included in your life, and parents always like that. Second of all, they’ll be more likely to believe you’ll be honest with them in general.

Teenagers who have diabetes may sometimes feel depressed. This is not uncommon. Feeling dragged down every now and then for a day or so is normal for anybody, but the symptoms of real depression typically last for more than a few weeks. They include:

  • Sleeping more than usual
  • Feeling hopeless; not enjoying the things you usually do
  • Having trouble studying or concentrating
  • Feeling tired all the time
  • Losing or gaining weight without really trying to
  • Thinking about death or suicide

If you think you may be experiencing depression, talk to your parents about it. If for any reason you don’t feel comfortable talking to them, talk to your CDE. People who are depressed may not feel like take care of themselves as well as they should, so it’s important to get treatment.

If there are issues between you and your parents that you’re having trouble solving, talk with your diabetes educator on your own. A CDE can suggest productive ways for dealing with your parents. It’s always more helpful to be able to talk with your parents calmly rather than getting into explosive arguments. And remember, if you can be calm and collected with your parents, they’ll see that as a sign of maturity, which will probably make things easier on you in the long run.

Consider getting the pump
The insulin pump allows for greater flexibility and can lead to improved glucose control. On the other hand, using the pump requires a big commitment.

Your doctor or diabetes educator should decide together whether the pump is right for you. The American Diabetes Association explains that the pump may be the best option for people who

  • Desire a more flexible lifestyle
  • Have difficulty controlling their blood sugar
  • Experience frequent, severe low blood sugar (hypoglycemia)

For teenagers, there are additional factors to weigh before starting the pump. An article in Diabetes Forecast notes that teens who are most likely to be successful with the pump are those who express a strong desire to use it. Other necessary characteristics include

  • Demonstrated responsibility in taking care of themselves
  • Supportive family
  • Easy access to someone who can help with dose regulation
  • Physical ability to manage the pump

For families who are unsure whether the pump is right for their teen, it may be possible to rent the device for a month or so. A diabetes educator will be able to help you and your teen determine the best steps to take when it comes to initiating pump use.

If your child is going away to college
Enlisting the help and support of people at your child’s school will help give you peace of mind. Making sure there are plenty of supplies is also important. Here are a few things to plan for:

  • Make sure the resident assistant in the dorm knows your child has diabetes and knows what to do in an emergency.
  • Tell your child’s friends and roommates about the diabetes and what to do in case of emergency.
  • Get a refrigerator for the dorm so your child has easy access to snacks.
  • Make sure your child has two glucose meters.
  • Provide about three months’ worth of snacks.
  • Keep copies of insurance and prescription cards with you in case they’re lost or stolen.
  • Make sure your child has a doctor at school.

The American Diabetes Association; N. Touchette. The Diabetes Problem Solver. The American Diabetes Association. 1999; Diabetes Forecast, March 1998; The Juvenile Diabetes Research Foundation
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