Helping Teens Manage Type 1 Diabetes

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In addition to the expected challenges of adolescence, teenagers with type 1 diabetes also must contend with the impact of fluctuating hormones on glucose levels. What's more, some teens may feel checking their blood sugar is a hassle, an inconvenience, or makes them feel different from their peers, and so they may not do it consistently—or at all.

For these reasons, it's no wonder up to 70% of adolescents who have diabetes do not have optimal control of their disease. However, vigilant and consistent management of diabetes is crucial for preventing serious complications. For teenagers, this means learning to balance self-care with school schedules, sports, first jobs, social commitments, learning to drive, and other life events.

Armed with an understanding of why this particular period of their life can be so impactful on their disease, most teens, with the help of trusted adults and the right tools, can get through adolescence and enter adulthood healthy and ready to manage their diabetes for the rest of their lives.

The Hormonal Impact

Over the course of puberty, as they grow and their hormones fluctuate, teenagers' bodies tend to become less sensitive to insulin. As a result, they're likely to experience high glucose levels and blood sugar swings that will continue until they reach their full growth.

For teens who are menstruating, the hormones responsible for menstruation can cause a rise in blood sugar. Menstruating teens who take insulin may require more insulin during their period. Tracking the menstrual cycle can be helpful to estimate when this might occur.

How to Encourage Good Self-Management

Uncontrolled diabetes may have short-term and long-term negative impacts on health: Short-term impacts include episodes of low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia), which, if left uncontrolled, may be life threatening.

Longer-term impacts of poor glycemic control include kidney damage (nephropathy), nerve damage (neuropathy), eye damage (retinopathy), and heart disease. This is why the teen years are an important time to instill good diabetes management skills.

Set a Schedule

As children with type 1 diabetes enter adolescence, they will need to gradually take over the daily management of their condition. A parent's goal during this time is to guide and support them.

One way to do this is to let them be part of the decision-making process as it applies to balancing lifestyle with insulin therapy, glucose testing, meals, and exercise. The discussion should focus on when (not whether) they do these things.

To that end, work with your teen to create a schedule and to underscore clear repercussions for what will happen if they don't stick to it—in terms of how it might affect their health as well as any penalties that might occur if, say, they stay out later than agreed on or skip testing their glucose or taking their insulin.

To help keep things on track:

  • Set phone reminders.
  • Keep a digital calendar that you both share, such as Google Calendar or Outlook Calendar.
  • Store a checklist of supplies on their phone and auto-subscribe to a delivery service so they don't run out.

Introduce an Insulin Pump or Patch

Insulin pump therapy involves a device that delivers continuous basal insulin throughout the day and night. Insulin pumps are more discrete than the needles and syringes necessary for traditional insulin administration and they allow for more freedom.

Studies have shown that children who use insulin pumps generally have lower hemoglobin A1C levels, lower hypoglycemia rates, and improved quality of life, especially when combined with continuous glucose monitoring (CGM).

Provide Support

All teens are prone to mood swings, but for those with type 1 diabetes what appears to be garden-variety adolescent angst or anger may be symptomatic of low blood sugar. It can be difficult to distinguish between a hypoglycemic event and brooding over a conflict with a friend. Let your child know they can come to you for emotional and nonjudgemental support during such times.

If they aren't comfortable with that or with talking to another family member or trusted friend, help them find a forum where they can express their emotions about the challenges they face.

Support groups can be incredibly helpful resources, as they connect teens going through similar issues and provide a nonjudgmental space for open discussion—especially online, where teens may create a pseudonym and anonymously post about sensitive or uncomfortable issues they may otherwise not be comfortable sharing in person.

Be On the Lookout for Depression

Teens with diabetes are more prone to become depressed than those not living with a chronic condition. However, according to the National Institute of Mental Health, depression can look different in teens than in children or adults. If you notice symptoms such as irritability, sulking, anxiety, disordered eating:

  • Discuss them with your teen's doctor.
  • Have your teen meet with a mental health counselor who understands type 1 diabetes. Your doctor should be able to recommend someone in your area.
  • Suggest your teen discuss school-related challenges with the school guidance counselor.

Talk About Sex, Drinking, and Drug Use

It's important that your teen is informed by a trusted adult about how these behaviors can affect blood sugar control, whether it's you, another family member, a therapist, or a doctor.

Be aware too that teens may need different tools, medications, and devices that fit their specific lifestyles, and it's important to be understanding about helping them best manage their own care. For example, as oral contraception can affect blood sugar levels, it's essential that sexually active females with diabetes work with their gynecologist and endocrinologist to find a hormonal birth control that works alongside the diabetes tools already in place.

Additionally, because alcohol and other drugs can lower blood sugar for up to 12 hours, teens must be aware of the signs and symptoms of hypoglycemia and know how to manage it.

A Word From Verywell

It's vital to empower your teen with type 1 diabetes with the tools and knowledge they need to manage their condition. Tap into the resources available to you, including your child's healthcare team, and be sure they understand you are a loving and nonjudgmental resource and support. Helping your teen build ownership of their diabetes management is a valuable skill they will need for the rest of their life.

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