Heart health is something most people start worrying about in middle age. There are biological and psychological reasons for this. Among the 54 adolescents aged 13 to 18 years and the 46 young adults aged 19 to 25 years, 78% and 89%, respectively, were not meeting HbA1c targets set by the American Diabetes Association. Teens were prompted with messages on their phones to take readings at regular intervals. Objective To identify the unique areas of diabetes-related distress (DD) for parents of teens with type 1 diabetes and parent and teen characteristics associated with DD. I know I’ve heard a few teens think a few of these thoughts: Left out of a party? Some of these reasons have to do with the disease and its treatment.
In class testing is preferred-this prevents lost educational time due to walking down to the office, testing and walking back. The prevalence of obesity did not increase during the study period, and study authors suggest this may explain why other cardiovascular risk factors like borderline-high and high low-density lipoprotein cholesterol and prehypertension/hypertension also plateaued. Whatever the case, when diabetes tasks don’t get done and parents find out, conflict typically erupts. “This supports the important idea that changes to your lifestyle choices are the key to improving cardiovascular risk status,” he added. But there are ways for parents and teens to work together for better diabetes control without continual nagging or frequent angry outbursts. How does diabetes affect sexuality and sexual behavior? Diabetes Control and Complications Trial Research Group.
Study data came from the U.S. Eating disorders have been reported in adolescent diabetics, particularly binge eating, however many adolescent girls and women have begun to take too little insulin in order to lose weight. The air is thick with tension as Jake sits slumped on the exam table with his face hidden under his ball cap and Mom sits on a chair with her arms crossed in front of her. “How are you doing today, Jake?” I ask. Usually a somewhat quiet but articulate young man, Jake mumbles something that sounds like, “OK. Health.com: Is it baby fat — or obesity? These changes cause muscle to extract sugar from the blood more efficiently.
Other kids at this point might argue with their parents, blame them for the missed blood glucose checks or boluses, roll their eyes, or even start crying. When that happens, I try to help both parties calm down, stop yelling or crying, and agree to listen quietly while the other talks so that constructive dialog can take place. Being willing to hear your teen’s perspective — without judgment or interruption — is an important step toward working as partners in his diabetes care. Crescitelli said she didn’t realize that even though children grow taller sometimes quickly as teenagers, they should not lose weight during growth spurts. Maybe he’s just had enough of diabetes and needs a less complicated diabetes-care regimen for a while. (His health-care team should be able to help with that.) Some kids cannot verbalize why they are not taking care of themselves, but others are surprisingly self-aware. Hearing what he does well is much more motivating to a teen (or an adult) than hearing what he does not do well.
It may help him to say more about why he’s not carrying out his diabetes care plan, and it may encourage him to try to do better at some of the tasks he is not currently doing well. It’s important for parents to remember that diabetes management can get tougher in the teenage years. The hormones that cause teens to grow and develop also cause insulin not to work as well, so the diabetes regimen that has worked well for years may need to be adjusted just as the teen is taking over more of his own care. In addition, going through puberty involves more than just physical changes; it’s an emotional time, too, and many kids have difficulty doing what they need to do at this time of life. It’s pretty common for kids with diabetes to slack off in their self-care efforts when they reach adolescence. This is stressful for parents, but it may be reassuring to know that it’s a normal stage that won’t necessarily last forever or lead to long-term diabetes complications. On the other hand, it’s not an excuse for teens to ignore or neglect their daily diabetes care.
Parents and teens need to negotiate how critical diabetes tasks will get done, where, when, and by whom. This is empathy, not pity. For example, you might say, “I care so much about your diabetes care because I love you and want a long healthy life for you!” Even if your teen rolls his eyes at this, it’s likely he’s taking in the message. Often, teens have their own solutions to problems that are more creative or practical than anyone else’s. In addition, if they are the ones to suggest it, it is more than likely an acceptable solution. I interject, “Well, Mrs. P, he’s telling you how you can help him right now.
And I agree that he is not going to learn to do it if he doesn’t do it. But for right now, in an effort to improve his control, and because this part is hard for him, do you think you could talk about how you might give him some help in this area?” Mom nods. Scare tactics — threatening your teen with kidney failure or blindness, for example — don’t work for anyone. But it’s still important for teens to know that their actions now can have both short-term and long-term effects. People with frequent or chronic high blood glucose over many years are the most likely to develop the devastating problems of eye, kidney, cardiovascular, and nerve disease, which can potentially lead to erectile dysfunction, heart attack, stroke, and amputations. Every little bit a person does to keep his blood glucose level in the near-normal range can lower his risk. It’s hard for teens (and often for adults, too) to believe these things could happen to them.
But often, teens can be disciplined about doing something today because it will benefit them sometime in the future. For example, many kids are willing to work hard in school so that they graduate from high school and can go to college. Or they are willing to save money over months or even years for a big expense such as college, a computer, or a car. Student athletes train and go to practice so they’ll do well later in competition. So it’s not unreasonable to ask teens to take steps now to raise the likelihood of good health in the future. Remind your teen of the short-term benefits of good blood glucose control, too, such as feeling better generally, having more energy for school and other activities, and receiving more privileges when parents are confident that the teen’s diabetes will be taken care of. You might also choose to reward your teen in some way for performing certain tasks or maintaining certain behaviors over a set period.
Taking ownership of one’s diabetes means accepting it and making it a priority. It doesn’t mean dealing with it all alone; even adults with diabetes need help sometimes or with some tasks. But it does mean being ultimately responsible for making sure it gets taken care of. Jake, who was diagnosed with diabetes at age seven, had never really taken charge of his diabetes because his parents had always done it for him. Now that he was 15, however, and spending more time away from his parents, it was time for him to take charge. I then ask Jake if he can identify any personal benefits he might get from making more of an effort at diabetes care, such as improved athletic performance or feeling more confident about his diabetes when he’s away from his parents. “No, this has been good.
This has been helpful. Jake, I want you to tell me and Dad what is helpful and what is not. Can you do that?” Jake nods yes again, although I’m not sure that he will do it without encouragement. Like most teens, he will probably take one step forward and two steps back as he works toward taking on these new responsibilities. With that in mind, I make one more suggestion, and that’s for Jake and his parents to have weekly meetings to go over his diabetes self-care. There are many variations on this story, and your teen may need help in different areas from Jake. But the approach described here — initiating a dialog, listening to what your teen has to say, and offering positive reinforcement and encouragement — can often get things moving in the right direction.
However, if you find that you and your teen continue to struggle in spite of your efforts, it might be helpful to talk to a counselor or to ask your teen’s diabetes care provider for a referral to a mental health care professional. Sometimes a few sessions are all that it takes to get over a tough spot and start moving forward again. A counselor would also be able to evaluate your teen for depression if that is a concern.