Butting Heads With Your Type 1 Teenager

Thank you for your comment.

Yes, my son has struggled with burn out with the testing, as I indicated. One thing I offered him to help reward him for dealing with this ongoing D management was that he could have a day off from school to sleep in and do something special like watch a movie. The stipulation was that he had to keep his grades up, turn in all of his homework and keep track of his BG (test + record his levels).

Alas, that carrot worked for the first five weeks of school until he had his first "reward day," and then he fell apart. We are now regrouping and assessing our next approach.

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Hi there: May I respectfully offer some advice?

Controlling diabetes as a teenager as well as watching the teen trying (or not trying as the case may be) to control his blood sugars is fraught with anxiety, frustration and, on occasion, anger by all parties involved (see the the Power of We  on this website). The reality is that the only thing a caregiver can actually do is to control your own behavior. You can't make the kid test blood sugars 4-8 times/day, bolus with every meal, and change sites every 3 days. What you CAN do is set the limits. Teens are like toddlers developmentally: they push the limits and it is up to the caregiver to set them. There are some things the teens cannot control: hormones, illness, stress etc: all causing erratic blood sugars. However, you control the signature on driver's licenses, car keys, money, cellphones, and rules. Diabetes self-care skills are a chore (and a pain as we know), but they are necessary and as a caregiver you can only do the best you can and set limits.. and hope they make some bit of difference.  Sadly, no matter what you do with your non-adherent teen (if indeed, he is truly non-adherent), diabetes control will remain labile and all you can do is wait until they have the epiphany and come to the realization that they actually care about themselves and want to live a long productive life.  

I see many patients like your son and it is frustrating for the kid, caregiver and diabetes healthcare team. Take advantage of having your son talk to a mental health care professional to help knock down the barriers preventing your son from being more adherent in caring for his diabetes. You, as caregiver, should also talk to a mental health professional, in order to validate your feelings in regard to the frustration of caring for a son that may( knowingly or unknowingly)be sabotaging his care.

LASTLY, make certain, of course, that there is no medical reason for his fluctuating blood sugars by ensuring that your diabetes team has exhausted all medical explanations and not just assuming that going to 50-500 in a single day is due to inattention to self care skills. There may actually be a medical fix for the instability of his blood sugars.

I hope I have addressed a least a fraction of your concerns and have been somewhat helpful.

Hello:

Since I've just started to deal with a teenager who is becoming rebellious about diabetes care, I've only begun to gather recommendations and pointers to share on how to deal with this maddening situation.

The purpose of the post was to both create a sense of solidarity and most importantly foster discussion and recommendations from those within the community (other caregivers, medical practitioners, and those with diabetes) who have experience with teenagers with diabetes. Dr. Cogen has begun this dialogue, and I hope you find some of her points of use. Too, I hope others will chime in.

Wishing you the best,

Beth McNamara

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