Meeting the challenges of type 1 diabetes in the teen years
Diabetes is never an easy disease to manage, but coping with type 1 diabetes can be a particularly difficult challenge for teens.
The transition from childhood to adolescence can be hard on both kids and parents, the JDRF (formerly the Juvenile Diabetes Research Foundation) says.
As boys and girls with type 1 diabetes enter puberty they undergo lots of changes, including increases in growth and appetite, which increases the need for insulin.
As children, eating was balanced with a ratio of one unit of insulin for every 30 grams of carbohydrates, but now they need one unit of insulin for 10 to 15 grams of carbohydrates, according to the foundation.
Sex hormones (estrogen and testosterone) also work against insulin. Insulin lowers blood sugar, but sex hormones raise it. Stress hormones, such as cortisol, also increase blood sugar, and teens can experience high levels of stress.
The emotional and social aspects of puberty can also make managing type 1 diabetes harder, the experts noted. It can be more difficult to manage blood sugar when peer pressure and a wide range of activities seem more pressing.
Teens can be preoccupied and forget boluses/injections, blood-sugar checks, necessary supplies and more.
Children going through puberty need more daily insulin. It's good to talk to your doctor about any sudden and unexpected spike and come up with a plan, the JDRF advised in a news release.
School can also become more demanding, especially if you're coping with type 1 diabetes. Studies show low, high or big swings in blood sugar affect the ability to focus.
Parents can take steps to help during this difficult time. A formal plan that schools develop to help support kids with medical needs, called a 504 plan, can allow students to delay or stop a test if their blood sugar is too high or too low.
Teens should check blood sugar before any test. But the last thing they want to do is feel different from everyone else or draw attention to their disease. So, it's important to have the 504 conversations at the start of the year.
For those with type 1 diabetes who play sports, that means trying to stay on top of their disease so they can focus on the game.
It helps to have a checklist:
- Be sure you have the supplies and glucose you need, a meter and insulin at any event. Ask the school athletic trainer who can administer glucagon.
- Have the sports gear you need. Be reasonable about the rules and expectations, but treating students with diabetes differently from other players won't help in the long run.
- Control your blood sugar. On a stage or a sports field, in a pool or on a track, people with type 1 diabetes do better if blood-sugar levels are within target ranges.
- Speak up when you need to take care of yourself. Find patterns that will be a good starting point for each practice and/or game.
Parents must help children learn to manage their diabetes on their own, the JDRF added. Don't hover. Take small steps to let teens handle activities independently.
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