Tuesday, October 26, 2010

Teens with Type-1 Diabetes

Parents with young children with type-1 diabetes know it's a lot of work to maintain good blood sugar control.  As your child gets older its great to see them improving in their responsibility and taking over more of their self care.  But don't be thinking that things will continue to get better all the time.  As these children reach their teen years they often seem to lose the skills they had been displaying just so recently before.  This downward slide can have several causes.
"I don't want to be different from my friends."
The teen years are a time of increased peer influence and decreased parent influence.  Fitting in with a social group is very important to teens.  As a parent of a child with diabetes, diabetes care is very important to you and that transferred to your child when you were the most important role model in the world to them.  As peers become more important it's easy for a teen to push diabetes care farther back in the list of things they want to deal with.
"I'll do it in a little while."
Teens have lots of good intentions to do what they say, but they are easily distracted by all the things and people around them.   Often the "I'll do it soon" turns into forgetting entirely.  As parents see a child mature intellectually they expect the child to be able to handle self scheduling.  Some teens do this well but quite a few do not.  Being a teen means living in the moment, living forever, and making a lot of mistakes.  Unfortunatly being a teen with diabetes makes having a schedule, facing your mortality and serious consequences a very real fact of life.
"I want to take care of myself."
  This can be a real dilemma for parents.  Too much self reliance often leads to poor diabetes control.  Too much interference leads to parental dependence and/or serious conflict.  Teens resent being told what to do, but often do the wrong thing.

What can a Parent do?
While I don't claim to have all the answers, a few things that have improved my teen's self care and my dealing with it are.
Enlisting Peer Support
Have your child's closest friends over and gently teach them a little about diabetes.  Children are curious and blood tests and shots facinate them.   As your child and their peers get older make sure the peers understand some of the consequences of poor diabetes management.  Close friends of a teenager pressuring them to take better care of themselves can be more effective than anything a parent might say.  Of course there are those friends that push each other into bad descisions so don't depend on this working every time.

Follow up and Observe
Ask your teen if they did their care and check to see if they really did.   If they are needing to do a test two hours after a meal and they say they'd get to it.  Ask them if they did it fifteen minutes later and look in the blood glucose meter's memory.  This will show you one of three things.  That they did what they said and you can trust them more, that they forgot and honestly admitted it or that they lied about doing it.  This will give you a much more accurate picture of what the teen's intention is and allows you to decide on an action to deal with it.

Work out a plan for gradually increasing self care.
Start with frequent checks of the teen's self care results, and if they are sucessfully  doing what is necessary the majority of the time back off the checks.  Expect some failure that will require increased intervention, but don't give up on the plan.  Just take a step back and start working toward the goal again.  Expect the teen to test limits, and try to initiate a power struggle.  Include the teen in the development of the plan, and help them to have realistic expectations.

There is much more that can be said on the subject of teens and type-1 diabetes.  If you are a parent of a teen or soon to be teen you have many challenges ahead of you, but a healthy, responsible and happy child makes it all worth while.

by Larry Luppen
Lupptech

Insulin Calculator App for Android

Insulin Calculator calculates insulin doses by entering blood glucose and carbohydrate values.  You can have multiple different insulin to carb ratios throughout the day. Figures correction based on blood glucose with ability to set a maximum correction dose.
It helps makes diabetes management easier.Insulin Calculator calculates insulin doses by entering blood glucose and carbohydrate values.  You can have multiple different insulin to carb ratios throughout the day. Figures correction based on blood glucose with ability to set a maximum correction dose.
It helps makes diabetes management easier.

 Diabetes Log App for Android

People living with diabetes know accurate data helps maintain better control. Diabetes Log keeps track of Blood Glucose, Carbohydrates, Insulin and Ketones. You can send .csv data to your computer via email. Manage your diabetes on the go discretely.

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