Diabetes Self-Management Articles

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When Your Teen Just Quits

by Jean Betschart Roemer, R.N., M.N., C.P.N.P., C.D.E.

Help your teen be accountable. I’m not suggesting that parents be the “diabetes police” but rather that the family work together toward helping the teen be responsible and accountable for the required tasks. Your child knows that the tasks are important and may skip them to test you to see how much you care. He is more likely to do a blood glucose check or take an injection if he knows you will be checking up on him. So let your teen know that you will be checking his meter memory or uploading his pump data to a computer periodically to see how he is doing. Many teens will not object to this accountability strategy when given advance notice. Even better is to let your teen know that you would like him to do the uploading and to review the data from his meter or pump with you at a set time each week. In this way, you can problem-solve issues together and strategize solutions to problems such as missing insulin doses. Your teen also should understand that the information may be communicated in some way to his health-care provider.

For teens whose diabetes is not in control, it can help to obtain HbA1c tests more frequently than every three months (the usual recommendation). A rising HbA1c can alert parents and teens to the need for action, while a decreasing HbA1c shows that diabetes control is improving and provides motivation to keep up the effort.

Help your teen fit diabetes care into his life. If your child is too busy or too disorganized to perform his diabetes care tasks, help to show him how it might be done. He may need to drop an activity — at least temporarily — to regroup. He may need some help with the organization of supplies or figuring out how to have time to take care of himself.

Stephen recently quit checking his blood glucose at lunch because he did not carry — nor did he want to carry — his meter with him, and it was out of the way to get to his locker, which was in another building, far from the cafeteria. When it became apparent that he was not monitoring his blood glucose level at lunch, and his diabetes control was suffering because of it, his parents asked him to strategize some possible ways to fix the problem. His sister suggested that he keep a meter in her locker, which was right next to the cafeteria. Nice sister…problem solved!

At times it may be helpful to give your teen a break from total responsibility for his diabetes care by giving him an injection, counting his carbohydrates for him, or setting out his monitoring supplies.

Simplify the regimen. When a teen is on a complicated insulin regimen, such as taking four to six injections a day or using an insulin pump, and isn’t doing well, it is often best to step back a bit to something easier. It is better to take three injections a day and get all your insulin than to supposedly be taking five injections a day and miss a couple of them. Some teens may need to take a break from their pump for a while if they can’t sustain the effort. Sometimes the flexibility of pump therapy normalizes life to the degree that kids forget they have diabetes — and consequently forget to take bolus insulin doses. If your teen isn’t sticking to his diabetes regimen, talk to your physician or educator about simplifying it.

Consider yourself. Think about your own feelings, expectations, and behaviors regarding your teen’s efforts to become more independent. Might you be holding the apron strings too tightly? Do you feel ambivalent about letting go? Are you giving mixed messages about your teen taking on more responsibility?

Parents often know they must encourage their teens to stand on their own two feet, but they have great difficulty doing so because of fear that their child will not rise to the challenge. Some parents prefer to be the ones in control for other reasons. And some parents — often inadvertently — convey the message that they are not interested, not willing, or too busy to be involved in their teens’ diabetes care. A close look at yourself may help to explain some of your teenager’s behavior.

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