Managing Type 1 Diabetes in Teens

The Physical and Emotional Changes

Smiling father and daughter embracing after driving lesson

Thomas Barwick/Getty Images 

It's hard enough being a teenager without adding type 1 diabetes to the mix. Not only do all teens experience various social and emotional struggles associated with growing up, such as self-esteem and a desire for independence, but teens with type 1 diabetes also must contend with wildly fluctuating hormonal changes that affect their blood sugar management. In addition, teens have the highest rates of poor self-management of the condition—up to 70% do not have optimal control of their disease, which can have long-term consequences.

The Hormonal Impact

Some teens may feel that consistently checking their blood sugar is a hassle or an inconvenience or makes them feel different from their peers, and so may avoid doing it. Managing type 1 diabetes requires consistent and thorough self-care, and with balancing busy school schedules, organized sports, first jobs, social commitments, learning to drive and other life events, it can be difficult for teens to always adequately prioritize their diabetes regimens.

However, the adolescent years are marked by hormonal changes that can have a very real effect on blood sugar.

As growth and puberty hormones increase during adolescence, teens' bodies become less sensitive to insulin, as the hormones that cause growth spurts can physiologically affect teens' blood sugar. As a result, high glucose levels and blood sugar swings may be common in teens, which can be stressful. When teens reach their full growth, these insulin-inhibiting hormones tend to decrease.

It's also important to note that 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.

Talk with your teen's doctor about the potential need to increase your teen’s insulin during these years to compensate for these changes.

How to Encourage Good Self-Management

Uncontrolled diabetes may have both 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. Which 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 empower the child.

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 determine 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

If your teen hasn't yet tried insulin pump therapy (a device that delivers a continuous amount of basal insulin throughout the day/night), it may be worth trying. Insulin pumps can deliver more discretion and freedom for busy adolescents who are less likely to check their glucose at regular intervals. Studies have shown that children who use insulin pumps generally have lower hemoglobin A1C levels, lower hypoglycemia rates, improved quality of life, especially when combined with continuous glucose monitoring (CGM), as well.

Bring in Outside Help

All teens are prone to mood swings, but for those with type 1 diabetes what may appear to be garden-variety adolescent angst or anger may be a symptom of low blood sugar. It can be difficult to distinguish between a hypoglycemic event and brooding over a conflict with a friend. Make certain your teen knows they can come to you with any emotional issues and that they will have your full support.

That said, all adolescents need a safe place to discuss their struggles about growing up and especially what they go through living with diabetes. Some feel comfortable talking with their parents; others may not. Regardless of whether your child opens up to you, another family member, or a trusted friend, they require a forum to express 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.

It’s also important to look for signs of depression in your teen. Though the normal hormonal changes of adolescence do not cause depression, teens with diabetes are more prone to become depressed than those not living with a chronic condition. If you notice symptoms of depression:

  • Discuss these symptoms 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 about how these behaviors will affect their blood sugar control. Make sure they have a trusted adult to talk openly with about managing their diabetes as well as about sex and using drugs or alcohol. This may be you or another parent or family member, a therapist, or a doctor.

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 over their diabetes management is a valuable skill they will need for the rest of their life.

Was this page helpful?
Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Ye CY, Jeppson TC, Kleinmaus EM, Kliems HM, Schopp JM, Cox ED. Outcomes That Matter to Teens With Type 1 DiabetesDiabetes Educ. 2017;43(3):251-259. doi:10.1177/0145721717699891

  2. Stanford Children's Health. Adolescents and Diabetes Mellitus.

  3. Centers for Disease Control and Prevention. Diabetes and Women. Updated Sept. 17, 2018.

  4. Ye CY, Jeppson TC, Kleinmaus EM, Kliems HM, Schopp JM, Cox ED. Outcomes that matter to teens with type 1 diabetesDiabetes Educ. 2017;43(3):251-259. doi:10.1177/0145721717699891

  5. Chiang JL, Maahs DM, Garvey KC, et al. Type 1 diabetes in children and adolescents: A position statement by the American Diabetes AssociationDiabetes Care. 2018;41(9):2026-2044. doi:10.2337/dci18-0023

  6. Cortés ME, Alfaro AA. The effects of hormonal contraceptives on glycemic regulationLinacre Q. 2014;81(3):209-218. doi:10.1179/2050854914Y.0000000023

  7. Johns Hopkins Medicine. Diabetes Education: Must Know Health Info: Mixing Alcohol with Your Diabetes.

Additional Reading