As children mature into teens, the pressures compound. Suddenly, they're worried about body image and weight and dealing with the temptations of alcohol and sex. (Gulp.) Add type 1 diabetes into the mix, and things get even hairier. How can parents make sure their teens stay safe while still giving them the space they need to grow? We consulted diabetes experts, teenagers, and parents on how to cope with some of the biggest issues facing teens today.
Staying a Healthy Weight
"I worried about weight gain in my teen years more than any time in my life," says Lorri Black, who was diagnosed with type 1 at age 15. It's a common concern -- especially for teens on insulin.
Eating a balanced diet can help your teen keep his or her weight on track, helping to eliminate any temptation to mess with meds as a way to drop pounds. Sports and exercise can be beneficial, too. Twelve-year-old Olivia Spradlin, who also has type 1, says she stays in shape by playing baseball, softball, and jumping on the trampoline. "My parents encourage me and let me be active," she says. "They also always try to reinforce healthy eating and portion sizes."
Aim to model positive body image for your teen, but don't overlook signs that he or she might be going through deeper issues. If you feel concerned your child is developing an unhealthy relationship with food, exercise, and/or weight, ask your diabetes care team for advice on getting professional help. Find more info here.
According to the National Institutes of Health, nearly three quarters of students (72 percent) have consumed more than just a few sips of alcohol by the end of high school, and more than a third (37 percent) have done so by eighth grade. So it's important to tell tweens and teens that you don't approve of underage drinking, and that drinking can have a very real impact on diabetes management.
"Alcohol can cause severe hypoglycemia several hours after drinking if done without adequate food intake," says certified diabetes educator Vandana Sheth, R.D. "It can also impair one's ability to identify and accurately treat symptoms of hypoglycemia."
That's what Spradlin's parents have tried to impress upon her. "My parents say it's very bad to drink -- especially for people with diabetes, because it can intensify the already not-so-fun effects diabetes causes when blood sugars are off," she explains.
Cara Gianni, whose 9-year-old son Milo was diagnosed with type 1 last year, says, "I was once a teenager, so I know drinking may happen," she says, despite the fact that alcohol is illegal for minors. "But I'm banking on Milo wanting to avoid the hospital at all costs. When the time comes to talk to him about this, I plan to strongly impress upon him the consequences of partying so that he won't want to do it."
It's important to communicate your own feelings, values and expectations about sex. Young people with type 1 should also know that an unplanned or hidden pregnancy can be particularly dangerous. Hormones produced by the placenta during pregnancy increase insulin resistance. As a pregnancy progresses and the placenta size increases, so do insulin requirements.
Moira McCarthy, author of a book for parents of children with type 1 diabetes and mother of a teenager diagnosed at age 6, says, "I've tried to tell my daughter how important it is for her to be honest with me so I can help her make things okay. It's not about being in trouble -- it's just really not safe to have an unplanned pregnancy when you have type 1 diabetes! As a result, she tells me everything."
Driving and type 1 diabetes can mix -- as long as your teen takes the proper precautions after getting his or her driver's license. Having good blood sugar management is essential, as driving with low blood sugar can be as dangerous as driving drunk.
"Have your child monitor their blood sugar before getting behind the wheel and they should pull over to check blood sugar levels every two hours when they're driving," Sheth warns. "If they're experiencing signs of hypoglycemia, they should pull over immediately and test again."
Keeping food and fruit juice in the car is a must. "They should plan ahead as far as meals and snacks go, depending upon the drive time," Sheth continues. "In addition to snacks with carbs, it's important to always carry glucose tablets, treatment for severe low blood sugar, a glucose meter, insulin, and a cell phone. And wear a medical ID at all times." (Interested in participating in new research about an education program for drivers with type 1 diabetes? Check out DiabetesDriving.com.)
Nobody says it will be easy -- but with honesty and open communication, you can raise a confident teenager with the best chance of growing into a happy and healthy adult.
Disclaimer: The experiences and suggestions recounted in these articles are not intended as medical advice, and they are not necessarily the "typical" experiences of families with a child who has type 1 diabetes. These situations are unique to the families depicted. Families should check with their healthcare professionals regarding the treatment of type 1 diabetes and the frequency of blood glucose monitoring.
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