Adolescents with diabetes
The adolescent years may be the most difficult time for a young person with diabetes and his or her parents. The normal cycle of rapid growth spurts and periods of slow growth along with the normal adolescent behaviours of going to bed late, sleeping late, and eating meals at varying times makes it difficult to keep an adolescent's blood sugar level consistently within his or her target range.
Eating "fast foods" frequently can make following a balanced diet and weight management difficult for an adolescent.
Your adolescent may be very mature and assume appropriate responsibility for his or her diabetes care. If so, your job as a parent of providing appropriate supervision will be relatively easy. On the other hand, adolescent rebellion is normal. Your adolescent with diabetes may rebel by lashing out at you for the ups and downs of the disease.
Your adolescent with diabetes may rebel by:
- Skipping insulin doses or, if he or she has type 2 diabetes, skipping his or her oral medication.
- Eating high-fat, high-calorie meals or eating whenever and whatever he or she wants, ignoring the daily meal plan.
- Falsifying or lying about blood sugar test results.
- Hiding or denying the disease when around his or her friends in an effort to "fit in."
These behaviours may lead to a serious problem with high blood sugar and even diabetic ketoacidosis.
Adolescents, especially girls, may try to control their weight by going on fad diets, vomiting after meals, or eating very little food. Because insulin can cause a person to gain weight, an adolescent also may skip doses in an effort to lose weight. This can be dangerous and may lead to high or low blood sugar emergencies as well as to an eating disorder.
Some things that may be helpful and decrease your tendency to nag your adolescent include:
- Keeping the disease in perspective—as only one part of a person's life. Encourage your adolescent to be as active as he or she would like to be in sports and other healthy activities.
- Not backing off completely, requiring that your adolescent assume total responsibility for his or her diabetes care. Accept the fact that ultimately it is up to your adolescent to take control of his or her care. Be there to support and guide. If you have encouraged your adolescent to assume more and more responsibility in the past and have given appropriate guidance and supervision, this transition of responsibility will be much smoother.
- Allowing your adolescent to meet with his or her diabetes health professional alone. This will encourage your adolescent to be highly involved in his or her care. A registered dietitian can work with your adolescent to develop a healthy meal plan.
- Not overreacting to high blood sugar levels. Everyone with diabetes has them from time to time. Praise your adolescent for checking his or her blood sugar level and problem-solve ways to handle it effectively.
- Using a flexible insulin dosing schedule with a combination of long-acting and rapid-acting insulins. This allows greater flexibility for those times when he or she sleeps late, attends parties, or alters the meal schedule.
- Using an insulin pump instead of multiple injections. Some young people really like using the insulin pump because it is a less obvious way of giving their insulin injections. If rapid-acting insulin is used with meals, the pump makes it convenient to give an extra dose if needed.
- Identifying a safety support system. Because low blood sugar levels are likely to occur, especially if your adolescent is keeping blood sugar levels tightly within a target range, he or she needs to have at least one friend who knows what to do in case of an emergency. Help your adolescent identify friends who can be a backup for safety. Discuss who else needs to know and what they need to know.
Talk to your diabetes team if you have serious concerns about your adolescent with diabetes.
| Author: | Douglas Dana Robin Parks, MS | Last Updated: August 15, 2007 |
| Medical Review: | Anne C. Poinier, MD - Internal Medicine Caroline S. Rhoads, MD - Internal Medicine Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology | |
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