If you have a teen with diabetes, you know how exhausting it is to help them with their self-care. You want to stay involved with monitoring blood sugar numbers like you did when he or she was younger, but you also want to give the independence teens crave.
“It’s quite difficult to achieve the appropriate balance between parental and childhood responsibility for the child’s diabetes,” says Dr. Michael Freemark, professor of pediatrics and chief of the Division of Pediatric Endocrinology and Diabetes at Duke University Medical Center in Durham, North Carolina.
And your teen often wants to ignore his or her diabetes. “Teens may be able to tell you what to do and the reasons why. However, the long-term is irrelevant to them,” says nurse practitioner and certified diabetes educator Ana Warren of Johns Hopkins All Children’s Hospital in St. Petersburg, Florida. “They don’t want to be different, and so they don’t want to check their blood sugar or take insulin in front of anyone. They want to eat and drink the same things as their friends.”
[Read: Why Diabetes Is on the Rise in Children and Teens.]
The perfect storm of hormones, peer pressure and emerging independence helps explain why only about 20 percent of teens with Type 1 diabetes meet hemoglobin A1C guidelines ( hemoglobin A1C measures the average blood sugar over the previous two to three months).
With all the dangers of diabetes self-management in the teen years, there are some steps that parents can take to help make the process a little easier.
Stay involved. It would be a relief to let your teen monitor his or her blood sugar numbers or administer insulin independently, right? However, your teen still needs you to help steer the diabetes ship, so to speak. Stay involved, and get more hands-on when blood glucose numbers are not doing as well as they should be, Warren advises.
It’s also important to show up at regularly scheduled doctors’ appointments for diabetes, Freemark recommends. He finds that missed clinic visits are often followed by a decrease in diabetic control. Use your check-ins with the doctor to go over realistic goals for better diabetes care, such as taking shots more regularly or reducing intake of sugary drinks, Freemark shares.
Set a weekly time to review blood sugar numbers. This gives your teen some leeway in monitoring blood sugar independently but also provides a set weekly time during which you review any trends in the numbers. This can help your teen avoid any risks for low or high blood sugar that are caused by food, physical activity or for other reasons.
Provide praise. “Parents should use frequent praise with teens to reinforce diabetes management behaviors that are working well and avoid anger or blaming if diabetes management is not going well,” says licensed clinical psychologist and certified diabetes educator Maureen Monaghan, an assistant professor of psychology and behavioral health at Children’s National Health System in the District of Columbia. “Glucose numbers are not good or bad — they are just a piece of information.” Staying positive and working together will be more effective in the long run. Even some control of blood glucose is better than no control, says Dr. Deena Adimoolam, an assistant professor of diabetes, endocrinology and bone Disease at the Icahn School of Medicine at Mount Sinai in New York. “Don’t expect perfection,” she says.
[Read: 9 Ways Teens Can Improve Diabetes Self-Care.]
Make changes as a family. If your teen is the only one in the family eating a certain way or avoiding soda, self-management becomes that much harder. If parents and others in the family can make at least some changes in their diet, self-care becomes a bit easier for your teen with diabetes, Freemark says.
Use technology to your advantage. Insulin pumps and continuous glucose monitoring that can help better manage diabetes are potentially great for teens. For instance, a study published this week in JAMA reported that in teens with Type 1 diabetes, insulin pump therapy was associated with a lower risk for severe low blood sugar and diabetic ketoacidosis, which is a life-threatening condition. “It highlights the great progress this technology has made,” says Dr. Ronald Tamler, medical director of Mount Sinai Clinical Diabetes Institute in New York.
Yet that doesn’t mean that pumps or monitors are right for everyone. Talk to your health care providers to find out what new technology may help your teen improve self-management. Work with your health care team to find out how technology can be made more affordable, Freemark suggests. “Patients with limited resources should not be denied access to new and highly effective technologies,” he adds.
You can also use newer management apps and software, some of which are stand-alone, and some of which are part of other technology. For instance, there are blood glucose meters that download results to apps and can make recommendations based on common patterns, Warren says. “Many patients have these technologies but don’t really maximize the capabilities,” she says.
Lend a helping hand for more challenging tasks. For instance, you can remind your teen to complete diabetes tasks at times they’re more likely to forget, or you can help out with potentially harder tasks like counting carbohydrates or calculating insulin doses, Monaghan advises. If those get too complicated for both you and your teen, a certified diabetes educator can also help teach the way to get those things done.
[Read: 5 Ways to Cope When a Family Member Has Diabetes.]
Watch for signs of depression and eating disorders. One trend diabetes health care providers see in teens is the purposeful omission of insulin to prevent weight gain; Warren says this is informally called diabulimia. This could eventually lead to serious health consequences such as diabetic ketoacidosis. Depression is also more common in teens with diabetes, and that can make management harder. “Depression and lack of diabetic control can interact to create a vicious cycle that is medically and psychologically debilitating,” Freemark says. Talk to your teen’s doctor if you are worried about eating disorders or depression.
Practice good self-care. “Seek your own support when needed,” Adimoolam advises. “It can be mentally and emotionally exhausting for parents, too.” Take time for yourself, even if it’s short.
Finally, stay patient. “In time, your child will understand the importance of diabetes treatment and management and appreciate all the help and care you’ve put in,” Adimoolam says.
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