Helping your young child understand and manage their type 1 diabetes is a completely different challenge than helping your preteen or teenager who lives with T1D. Just when you thought you were one step closer to mastering the art of parenting a child with a chronic condition, puberty arrives. Yikes!
You’ve lived through puberty and came out the other side, so you know how difficult it is for teenagers to tolerate all the changes to their bodies. Their emotions are uncontrollable because of their hormones, social pressure to fit in, and perhaps the emerging awareness of their budding sexuality. Their skin, weight, voices, and height may rapidly change during this time. School work, extracurriculars, and their social groups will start to ask more of teens, and the added time and commitment can alter their schedule. It’s a lot to balance. Unfortunately, type 1 diabetes does not choose to sit quietly on the sidelines while these changes take over.
Managing T1D in teens can be rollercoaster
Not only do hormones affect your teen’s mood, but they can also wreak havoc on your teen’s blood sugar levels. Their insulin resistance may increase or decrease without rhyme or reason, their appetite may change in ways that make it harder for them to maintain a healthy diet, and their body’s absorption time for different types of carbs may rapidly switch. In short, everything is subject to change. In the short term, your teen won’t understand these changes or how to counteract them, and their A1C may rise or fall dramatically as a result. Even if your teen follows all management protocols set by their endocrinologist, they may be unable to maintain normal blood sugar levels.
A recent study showed that 70% of adolescents who have diabetes do not have optimal control of their condition. Data from JDRF has also shown that CGMs do not help with improving teens’ A1C. It is completely normal for the changes of puberty to affect your teen’s diabetes.
Tips for managing your teen’s T1D
So, what are you to do? First and foremost, the best thing you can do is to maintain healthy habits as a family. Try to exercise regularly, eat healthy foods, and get plenty of sleep. These are the best defenses your teen has against their hormones.
1. Approach rebelliousness with compassion
Your teen may start to direct some of their rebellious teenage energy toward their diabetes management. You may find that they skip blood sugar checks, site changes, or insulin injections while out with friends or busy with other activities.
If you notice avoidant behavior around your teen’s diabetes management starting, address it directly with compassion and understanding. Using scare-tactics, guilt-tripping your teen, or grounding them will only make them feel more limited and controlled by their condition. It will also make them see you as someone who will judge, rather than help, when they are overwhelmed by their diabetes management.
2. Open up a conversation about depressions and mental health
Living with a chronic condition through this emotional phase of life is not to be taken lightly. It’s possible that your teen may start to suffer from depression. In teens, depression can look like irritability, sulking, anxiety, or disordered eating. Because people living with type 1 diabetes are 2 to 3 times more likely to suffer from depression at some point in their life, you need to be prepared to discuss mental health with your teen.
If you find yourself in this predicament, talk to your teen. Ask them if anything is weighing on them. Discuss their response at length rather than dismissing what they have to say. Though it may seem trivial to fixate on things like getting a crush to like them back, this could be a contributor to your teen’s neglect of their diabetes management. Make a conscious effort to open up a conversation free of judgment or shame. Many preteens and teens are hesitant to talk to their parents about their feelings, so be sure to set the scene as a comfortable one. Take them for a drive to get their favorite treat or go for a walk to their favorite spot. Keep their comfort in mind when broaching this topic.
When it feels right, you may want to segway into discussing your concerns around your teen’s new management strategies (or lack thereof). First, tell him/her that you want them to be happy and healthy above all. These are keys to a good life. Remind them that they have more work required for their health than their peers. Though it is unfair, it’s also not the end of the world. Your teen can have a thriving social life, fun extracurriculars, a strong relationship with their family, and strong physical health all at once. If you know any adults with type 1 diabetes, see if you can initiate a conversation between them and your teen. This family friend may be able to approach the conversation with more understanding and insight, and your teen could be more receptive to that.
3. Connect with other T1Ds, especially those your teen looks up to
This may also be a great time to point your teen toward the long list of successful actors, athletes, musicians, lawmakers, and more who live with type 1 diabetes. Connections to other type 1 diabetic people can make your teen feel less alone, and it can be helpful for them to find a role model to look up to. See if there is a noteworthy individual with type 1 diabetes participating in the interests and activities that your teen enjoys. Do they have a book? Have they been interviewed on a podcast? Explore what real world sources are available. The less you rely on clinical material directly from a doctor’s office, the more likely your teen is to engage.
4. Remember that this phase will pass
Remember that there will be days when things go wrong. When you aren’t around, your teen is going to eat things they shouldn’t. Maybe they’ll get less sleep than they need at their growing age. Their body will be overtaken by hormones beyond their control, and those hormones will make a tough challenge even harder. Remember that this phase of life will pass. Protecting your teen’s mental health is just as important as protecting their physical health. Lecturing, yelling, and punishing does not help. If you show your teen that you are a trustworthy, non-judgmental ally in their diabetes management, you can create a lasting bond, and you can show them the importance of mental AND physical wellness.
Validate their frustrations, fear, and struggles to open the door for them to take your advice. Once you have done this, lead your conversations with kindness and compassion. By reminding your teen that you simply want to see them healthy and happy in life, you can avoid making them feel shame, embarrassment, or fear about their diabetes. This will set a path for lifelong mental wellness as they continue to manage their condition.