A teenager aged 13-17 years with or without diabetes
Teenage years are a time of feeling different,
making changes, testing limits, experimenting with decision making, making
mistakes, challenging adult rules, feeling that nothing can go wrong, risk
taking, enjoying life, looking forward to new challenges.
The teenager:
• May feel caught between their inner drives, peer group pressure and family expectations
• Is very self-conscious about physical development, physical health, sexuality
• Values possessions, popularity and status
• Develops "crushes" on peers
• Becomes angry with what they see as interference of parents in their life.
• May be moody and irritable
• Begins to reason and see things from different points of view
• Begins to handle a wider range of problems
• Seeks and develops a close circle of friends for social support and generally becomes more social
• May feel caught between their inner drives, peer group pressure and family expectations
• Is very self-conscious about physical development, physical health, sexuality
• Values possessions, popularity and status
• Develops "crushes" on peers
• Becomes angry with what they see as interference of parents in their life.
• May be moody and irritable
• Begins to reason and see things from different points of view
• Begins to handle a wider range of problems
• Seeks and develops a close circle of friends for social support and generally becomes more social
When a 13-17 year old is diagnosed with diabetes
•They may feel more and more angry having to
consider their diabetes before they can do things that their friends take for
granted, staying out late, applying for a driving licence
• They may find that eating, drinking, trying things out and general socialising with friends puts pressure on them as they try to be one of the gang and manage their diabetes
• There may be problems with willingness to carry out their diabetes management. It may become just too limiting, stopping them doing more interesting things
• The need to be accepted and being seen as attractive are of great importance. diabetes is seen as a hindrance to friendship and relationships
• They may find that the career path they want to pursue is one of the very few that excludes people with diabetes
OR
• They may sail through adolescence, managing everything beautifully including their diabetes!!
• They may find that eating, drinking, trying things out and general socialising with friends puts pressure on them as they try to be one of the gang and manage their diabetes
• There may be problems with willingness to carry out their diabetes management. It may become just too limiting, stopping them doing more interesting things
• The need to be accepted and being seen as attractive are of great importance. diabetes is seen as a hindrance to friendship and relationships
• They may find that the career path they want to pursue is one of the very few that excludes people with diabetes
OR
• They may sail through adolescence, managing everything beautifully including their diabetes!!
Living with diabetes
As your teenager
progresses through the teenage years
• This age group gradually takes over all of their diabetes care, although it is important for them to have your support, encouragement and sometimes, advice. Continuing education sessions with the diabetes team will also help
• You and your teenager may become frustrated and irritated on occasions when there is lack of consistency of blood glucose results despite the effort put into insulin adjustments, exercise and diet. Blood glucose levels (BGLs) may be erratic due to varied activity and food intake, stress, varied rates of growth and development, hormonal changes, behavioural problems or difficulty adhering to diabetes routines
• Willingness to carry out diabetes management is sometimes a problem as the need for a routine interferes with a carefree existence. Doing things on the spur of the moment may be difficult and the need for adult supervision is still there, despite wanting to do their own thing
• The fear and embarrassment of hypos occurring in public may cause your teenager to 'run' their BGLs high
• Activity is often varied at this age and blood glucose levels may follow suit!
• 13-17 year olds may be more willing to have multiple injections once they realise it may give them more flexibility in their everyday life. This is not the best option for all teenagers, it may encourage them to skip their insulin injections. They may also start to use devices such as insulin pens or pumps which may make life easier
• Trying things out is a part of this age group's everyday life - it is important that your teenager understands the implications of drugs and alcohol and their possible influence on the management of their diabetes
• It’s important that you 'keep the door open' for when your teenager wants advice
• This age group gradually takes over all of their diabetes care, although it is important for them to have your support, encouragement and sometimes, advice. Continuing education sessions with the diabetes team will also help
• You and your teenager may become frustrated and irritated on occasions when there is lack of consistency of blood glucose results despite the effort put into insulin adjustments, exercise and diet. Blood glucose levels (BGLs) may be erratic due to varied activity and food intake, stress, varied rates of growth and development, hormonal changes, behavioural problems or difficulty adhering to diabetes routines
• Willingness to carry out diabetes management is sometimes a problem as the need for a routine interferes with a carefree existence. Doing things on the spur of the moment may be difficult and the need for adult supervision is still there, despite wanting to do their own thing
• The fear and embarrassment of hypos occurring in public may cause your teenager to 'run' their BGLs high
• Activity is often varied at this age and blood glucose levels may follow suit!
• 13-17 year olds may be more willing to have multiple injections once they realise it may give them more flexibility in their everyday life. This is not the best option for all teenagers, it may encourage them to skip their insulin injections. They may also start to use devices such as insulin pens or pumps which may make life easier
• Trying things out is a part of this age group's everyday life - it is important that your teenager understands the implications of drugs and alcohol and their possible influence on the management of their diabetes
• It’s important that you 'keep the door open' for when your teenager wants advice
Coping from Day to Day
The difficult thing for any parent is letting go. When your child has diabetes it can be even more difficult. It's not easy to let go and encourage independence. Your understandable concern may be perceived as lack of trust.
The difficult thing for any parent is letting go. When your child has diabetes it can be even more difficult. It's not easy to let go and encourage independence. Your understandable concern may be perceived as lack of trust.
Changes in their diabetes management plan should be
talked over with your teenager. This is a scary time for them. They want
independence yet don't want to feel alone or ignored. Finding that happy medium
between enough supervision and letting go is a real challenge for any parent!!
Here are a few tips:
Negotiate
This is a great way for your teenager to learn to deal with others. Your concern may be seen as nagging, causing anger and resentment. However, your teenager may need to be reminded that your questions arise from concern and that it's part of your responsibility as a parent. You may even need to negotiate your negotiations such as "What can we do so that you don't feel I'm nagging and I know you're OK?"
This is a great way for your teenager to learn to deal with others. Your concern may be seen as nagging, causing anger and resentment. However, your teenager may need to be reminded that your questions arise from concern and that it's part of your responsibility as a parent. You may even need to negotiate your negotiations such as "What can we do so that you don't feel I'm nagging and I know you're OK?"
Be consistent
Some rules are flexible but injections cannot be forgotten! Identification should be worn! Hypo food should be on hand! It is important to set clear limits. Teenagers need consistent rules to feel safe, but also need parents who can look at each situation on its own merit and decide when rules can be relaxed!!
Some rules are flexible but injections cannot be forgotten! Identification should be worn! Hypo food should be on hand! It is important to set clear limits. Teenagers need consistent rules to feel safe, but also need parents who can look at each situation on its own merit and decide when rules can be relaxed!!
Keep communicating
It may be strained at times but maintain the lines of communication. Your teenager needs to learn how to problem solve and subsequently make decisions. Their way of doing things may not be yours and there may be much discussion!
It may be strained at times but maintain the lines of communication. Your teenager needs to learn how to problem solve and subsequently make decisions. Their way of doing things may not be yours and there may be much discussion!
Ask how you can help
They may ask you to draw up their insulin once in a while or do some blood glucose recordings for them. Once they see that you are helping and not just interfering they are more likely to respond.
They may ask you to draw up their insulin once in a while or do some blood glucose recordings for them. Once they see that you are helping and not just interfering they are more likely to respond.
Give praise
When things are going well, praise your teenager on their management and sense of responsibility. Sometimes things don't go well despite everyone's efforts, and acknowledgement of this is important. Remind them that the payoff for being granted more freedom is for them to gradually take on more responsibility.
When things are going well, praise your teenager on their management and sense of responsibility. Sometimes things don't go well despite everyone's efforts, and acknowledgement of this is important. Remind them that the payoff for being granted more freedom is for them to gradually take on more responsibility.
Be understanding
Recognise the frustrations for your teenager when things are not going so well.
Recognise the frustrations for your teenager when things are not going so well.
Be patient
This is a difficult time for all of you. Remember that things will get better.
This is a difficult time for all of you. Remember that things will get better.
To care for your
teenager you must care for yourself
diabetes takes a lot of time and energy so it's normal to feel frustrated and tired from the constant daily demands of management. Your emotions may change and recur (perhaps often) - guilt, frustration, helplessness, sadness, anger... and elation when all goes according to plan! Here are some tips on how to cope:
diabetes takes a lot of time and energy so it's normal to feel frustrated and tired from the constant daily demands of management. Your emotions may change and recur (perhaps often) - guilt, frustration, helplessness, sadness, anger... and elation when all goes according to plan! Here are some tips on how to cope:
• Talk to someone who may understand, such as other
parents of a teenager in the same situation
• Share your feelings with your partner, a friend or relative, support groups, your doctor, other health professionals such as a social worker or psychologist
• Share diabetes-related tasks with your partner
• Keep in touch with your educator as ongoing education can help you and your teen at different stages
• Don't be afraid to ask your health professional team for support and guidance.
• Encourage relatives or friends to attend education sessions and/or support groups to learn more about diabetes so that they may in turn give you support
• Camps are a good way to introduce your teenager to others going through the same things. These camps are only for teenagers with Type 1 diabetes and are divided into age-appropriate groups - 13-14 years and 15-17 years
• Find some time for yourself. It's worthwhile for the daily demands of parenting
• Share your feelings with your partner, a friend or relative, support groups, your doctor, other health professionals such as a social worker or psychologist
• Share diabetes-related tasks with your partner
• Keep in touch with your educator as ongoing education can help you and your teen at different stages
• Don't be afraid to ask your health professional team for support and guidance.
• Encourage relatives or friends to attend education sessions and/or support groups to learn more about diabetes so that they may in turn give you support
• Camps are a good way to introduce your teenager to others going through the same things. These camps are only for teenagers with Type 1 diabetes and are divided into age-appropriate groups - 13-14 years and 15-17 years
• Find some time for yourself. It's worthwhile for the daily demands of parenting
Siblings
• Brothers and sisters may not like the sudden focus on the child with diabetes - Why all the fuss? Why do we have to rush home for injections? Why do we have to worry about food all the time? Your child with diabetes may well take advantage of this
• Brothers and sisters who previously had no axe to grind may suddenly find one. If they thought their brother or sister were the favourite prior to having diabetes, this may add to the problem
• Brothers and sisters may fear that they will be loved less and pushed to one side in favour of the child with diabetes
• Brothers and sisters may not like the sudden focus on the child with diabetes - Why all the fuss? Why do we have to rush home for injections? Why do we have to worry about food all the time? Your child with diabetes may well take advantage of this
• Brothers and sisters who previously had no axe to grind may suddenly find one. If they thought their brother or sister were the favourite prior to having diabetes, this may add to the problem
• Brothers and sisters may fear that they will be loved less and pushed to one side in favour of the child with diabetes
Ideas for coping:
• Try to keep things as normal as you can (not always easy) and play down the diabetes as much as is possible. Try and spend some special time alone with your child without diabetes, doing something fun and that they really enjoy
• Be consistent in the way you discipline all your children
• Some children worry that diabetes is catching or that their brother or sister with diabetes might die. They may think that something they have done has given their brother or sister diabetes - such as breaking a toy or not sharing. They may have nightmares, suddenly start wetting the bed or cling to you (Remember that there are health professionals to help you and your family). Your child's brothers and sisters need to know what is happening and to feel involved
• Families often find that they have become closer because of diabetes, so problems can be sorted out with patience and understanding
• Involving siblings in the initial diabetes education when appropriate may help
• Try to keep things as normal as you can (not always easy) and play down the diabetes as much as is possible. Try and spend some special time alone with your child without diabetes, doing something fun and that they really enjoy
• Be consistent in the way you discipline all your children
• Some children worry that diabetes is catching or that their brother or sister with diabetes might die. They may think that something they have done has given their brother or sister diabetes - such as breaking a toy or not sharing. They may have nightmares, suddenly start wetting the bed or cling to you (Remember that there are health professionals to help you and your family). Your child's brothers and sisters need to know what is happening and to feel involved
• Families often find that they have become closer because of diabetes, so problems can be sorted out with patience and understanding
• Involving siblings in the initial diabetes education when appropriate may help
Physical Activity
Teenagers with diabetes should be encouraged to exercise regularly, the same as their peers. When doing any physical activity your teenager may have to adjust their diabetes routine.
• Experience and frequent blood glucose monitoring help determine the most appropriate way to deal with this – everyone responds differently
• Exercise increases the body's sensitivity to insulin (increasing the risk of hypos) and this effect may continue for 12 to 16 hours following the activity
• Blood glucose levels need to be measured before, during and after exercise
• Extra carbohydrate foods are often required before, during and after exercise, depending on BGLs and type of activity. For moderate and intense activities a general rule is one extra carbohydrate exchange / serve for every 30-40 minutes of exercise
• It’s important that your teenager packs a hypo kit to take with them to sport
• Exercise should be avoided if the BGL is above 15mmol/L particularly if ketones are present
Teenagers with diabetes should be encouraged to exercise regularly, the same as their peers. When doing any physical activity your teenager may have to adjust their diabetes routine.
• Experience and frequent blood glucose monitoring help determine the most appropriate way to deal with this – everyone responds differently
• Exercise increases the body's sensitivity to insulin (increasing the risk of hypos) and this effect may continue for 12 to 16 hours following the activity
• Blood glucose levels need to be measured before, during and after exercise
• Extra carbohydrate foods are often required before, during and after exercise, depending on BGLs and type of activity. For moderate and intense activities a general rule is one extra carbohydrate exchange / serve for every 30-40 minutes of exercise
• It’s important that your teenager packs a hypo kit to take with them to sport
• Exercise should be avoided if the BGL is above 15mmol/L particularly if ketones are present
Activities to be
approached with caution
• Activities that are solos in nature, take place in water or mid-air, or limit the individual’s ability to recognise and self-treat hypoglycaemia
• The Australian diabetes Society recommends that Type 1 diabetes is an absolute contraindication to Entry Level (qualified to plan and execute dives to 18 meter SCUBA diving)
Driving
When your teenager first mentions learning to drive, don't panic!! Any parent is anxious when their teenager wants to learn to drive. However, with a responsible attitude, driving is generally safe and research shows that people with diabetes do not have a greater frequency of motor accidents than anyone else. The major added risk for the teenager with diabetes is hypoglycaemia.
• Activities that are solos in nature, take place in water or mid-air, or limit the individual’s ability to recognise and self-treat hypoglycaemia
• The Australian diabetes Society recommends that Type 1 diabetes is an absolute contraindication to Entry Level (qualified to plan and execute dives to 18 meter SCUBA diving)
Driving
When your teenager first mentions learning to drive, don't panic!! Any parent is anxious when their teenager wants to learn to drive. However, with a responsible attitude, driving is generally safe and research shows that people with diabetes do not have a greater frequency of motor accidents than anyone else. The major added risk for the teenager with diabetes is hypoglycaemia.
• It is very important that they have a good
knowledge about hypoglycaemia, its treatment and prevention• Driving and alcohol is not a good mix at any time and in a teenager with diabetes, it may cause delayed hypos
• It is wise for your teenager to check their blood glucose prior to driving a car and to have hypo treatment readily at hand
• Each State and Territory has its own regulations regarding the allocation of licences to people with diabetes
• For further information on driving and Type 1 diabetes visit: www.austroads.com.au
School
Your teenager may find that hiding their diabetes
takes less energy than explaining and confronting it. Usually a few close
friends are OK to tell, but they may not be keen to tell their teachers. This
may cause problems if they have a hypo in class - if they eat something in
class it will draw more attention to them. It is therefore important to
encourage them to tell their main teachers, especially those who supervise
sport. Telling them can prevent misunderstandings, for instance, when they have
to suddenly leave the game to get an orange juice.
Three good reasons for your teenager to let the
teachers know that they have diabetes:
1. Safety - So that the staff are aware that a
student has diabetes.
2. Convenience - They may have to eat a snack in class or on the sports field or leave the room for an injection. A hypo may make them lose concentration and appear inattentive. An understanding teacher may make life a lot easier.
3. Because they want to - One teacher may be someone they particularly relate to and talking about their diabetes is part of talking about themselves.
2. Convenience - They may have to eat a snack in class or on the sports field or leave the room for an injection. A hypo may make them lose concentration and appear inattentive. An understanding teacher may make life a lot easier.
3. Because they want to - One teacher may be someone they particularly relate to and talking about their diabetes is part of talking about themselves.
If your teenager doesn't want diabetes mentioned
they have a right to privacy. However, their school should have official notice
with a letter in their school medical records. If they don't want their
diabetes mentioned during class, they should let their teachers and friends
know that this is their wish.
Despite your teenager being reluctant for you to
speak to their teachers, it is important to stress to them that authorities
should be notified of their diabetes from a safety/legal point of view. Your
diabetes educator or an educator from diabetes Australia may be able to help.
Alternatively one of your teenager's friends may persuade them.
Your teenager may have to be the teacher regarding
diabetes. Teachers and friends cannot be expected to understand problems
relating to diabetes until they know more about it.
For more information about managing diabetes at
school click here.
Examinations
In New South Wales there are four programs which deal with illness / misadventure and exam conditions for students with any difficulty.
1. School assessment policies. Determined and ruled by individual schools/colleges. They include arrangements in case of illness (hypo during an examination).
2. Special examination provisions. Run by the Board of Studies for the School Certificate Reference tests and HSC examinations.
3. Illness/misadventure program. Run by the Board of Studies for the HSC. It involves illness or misadventure immediately prior to, or during, the examinations.
4. Special access to universities. Run entirely by universities. Students who have experienced difficulties during Year 12, contact each university to whom they wish to apply, and ask for information on their special access program.
In New South Wales there are four programs which deal with illness / misadventure and exam conditions for students with any difficulty.
1. School assessment policies. Determined and ruled by individual schools/colleges. They include arrangements in case of illness (hypo during an examination).
2. Special examination provisions. Run by the Board of Studies for the School Certificate Reference tests and HSC examinations.
3. Illness/misadventure program. Run by the Board of Studies for the HSC. It involves illness or misadventure immediately prior to, or during, the examinations.
4. Special access to universities. Run entirely by universities. Students who have experienced difficulties during Year 12, contact each university to whom they wish to apply, and ask for information on their special access program.
HSC/State Examination
In some States the school is required to send an "Application for Candidates with Disabilities" form together with a medical certificate, to the "Special Provisions for Students with Disabilities" Program at the Board of Studies. This is to be done six to twelve months prior to the examination.
During examinations the student is usually allowed to:
• Take bite-sized carbohydrate food such as dried fruit (but no noisy wrappers) to 'top-up' blood glucose levels throughout a lengthy exam
• Be seated near an exit so others are not disturbed if the student has to leave the room
• Take a blood glucose meter and test strips into the exam room
• Have a maximum of 5 minutes extra time per half hour of exam time for toilet breaks
• Have a maximum of 20 minutes extra time per exam to take remedial action if required
• Be seated in a separate room with a supervisor
• Take their insulin pump into the examination room and operate it according to medically prescribed guidelines
In some States the school is required to send an "Application for Candidates with Disabilities" form together with a medical certificate, to the "Special Provisions for Students with Disabilities" Program at the Board of Studies. This is to be done six to twelve months prior to the examination.
During examinations the student is usually allowed to:
• Take bite-sized carbohydrate food such as dried fruit (but no noisy wrappers) to 'top-up' blood glucose levels throughout a lengthy exam
• Be seated near an exit so others are not disturbed if the student has to leave the room
• Take a blood glucose meter and test strips into the exam room
• Have a maximum of 5 minutes extra time per half hour of exam time for toilet breaks
• Have a maximum of 20 minutes extra time per exam to take remedial action if required
• Be seated in a separate room with a supervisor
• Take their insulin pump into the examination room and operate it according to medically prescribed guidelines
Special provisions are made on an individual basis
with recommendations from your doctor. The student who experiences a hypo
during the HSC (or equivalent) should apply to be treated as an “illness or
misadventure case”. Students treated in this way can usually receive a mark
based on a school assessment instead of their examination mark.
You can obtain further information from your
teenager's school, diabetes Australia in your State or Territory or The
Department of Education. These are listed below for your convenience.
New South Wales
Board of Studies NSW
117 Clarence Street, Sydney NSW 2000
GPO Box 5300, Sydney NSW 2001
Ph: 02 9367 8111
Board of Studies NSW
117 Clarence Street, Sydney NSW 2000
GPO Box 5300, Sydney NSW 2001
Ph: 02 9367 8111
Victoria
Victorian Curriculum to Assessment Authority
41 St Andrew’s Place East Melbourne Victoria 3002
Ph: 03 9651 4300
Victorian Curriculum to Assessment Authority
41 St Andrew’s Place East Melbourne Victoria 3002
Ph: 03 9651 4300
Tasmania
Tasmania Qualifications Authority
PO Box 147, Sandy Bay TAS 7006
Ph: 03 6233 6364
Tasmania Qualifications Authority
PO Box 147, Sandy Bay TAS 7006
Ph: 03 6233 6364
South Australia
Senior Secondary Assessment Board of South Australia
60 Greenhill Rd, Wayville SA 5034
Ph: 08 8372 7400
Senior Secondary Assessment Board of South Australia
60 Greenhill Rd, Wayville SA 5034
Ph: 08 8372 7400
Western Australia
Curriculum Council
27 Walters Drive, Osborne Park WA 6017
Ph: 08 9273 6300
Curriculum Council
27 Walters Drive, Osborne Park WA 6017
Ph: 08 9273 6300
Queensland
Queensland Studies Authority
Level 7, 295 Ann Street, Brisbane
PO Box 307, Spring Hill QLD 4004
Ph: 07 3864 0299
Queensland Studies Authority
Level 7, 295 Ann Street, Brisbane
PO Box 307, Spring Hill QLD 4004
Ph: 07 3864 0299
Australian Capital
Territory
ACT Board of Secondary Studies
186 Reed St Tuggeranong ACT 2900
PO Box 2901 , Tuggeranong ACT 2901
Ph: 02 6205 7162
ACT Board of Secondary Studies
186 Reed St Tuggeranong ACT 2900
PO Box 2901 , Tuggeranong ACT 2901
Ph: 02 6205 7162
Northern Territory
Northern Territory Board of Studies
14th Floor, Mitchell Centre, Mitchell St NT 0800
GPO Box 4821, Darwin NT 0801
PH: 08 8999 5767
Northern Territory Board of Studies
14th Floor, Mitchell Centre, Mitchell St NT 0800
GPO Box 4821, Darwin NT 0801
PH: 08 8999 5767
Career options
In recent years a number of workplace discrimination cases against people with diabetes have been successfully challenged in the courts. With improved understanding and management of diabetes there are now few occupations from which people with diabetes are excluded.
In recent years a number of workplace discrimination cases against people with diabetes have been successfully challenged in the courts. With improved understanding and management of diabetes there are now few occupations from which people with diabetes are excluded.
Should your teenager need further information
regarding career options, please call diabetes Australia in your State or
Territory.
Risky Business
• Your teenager with diabetes is just like other
teenagers, and is just as likely to take risks with their health. This occurs
particularly in early teenage years when it is more important to be like their
friends and to fit in socially, than it is to display healthy behaviour!
• Your teenager sees themselves as unstoppable and doesn't believe they could become addicted to something harmful, or that anything could go terribly wrong in their lives
• It's natural for you to worry that your teenager might make wrong choices. Mistakes will happen and usually lessons will be learned! This is a normal part of growing up
• Puberty in both boys and girls is a time when the need for insulin increases. Your teenager's blood glucose control will vary with growth and hormonal changes
• Your teenager sees themselves as unstoppable and doesn't believe they could become addicted to something harmful, or that anything could go terribly wrong in their lives
• It's natural for you to worry that your teenager might make wrong choices. Mistakes will happen and usually lessons will be learned! This is a normal part of growing up
• Puberty in both boys and girls is a time when the need for insulin increases. Your teenager's blood glucose control will vary with growth and hormonal changes
Smoking
Smoking is harmful to the health of everyone no matter what their age and smoking should be discouraged in people with diabetes. Nicotine damages blood vessels. Smoking is also associated with high blood pressure, poor diabetes control and has additional risks in pregnancy.
Smoking is harmful to the health of everyone no matter what their age and smoking should be discouraged in people with diabetes. Nicotine damages blood vessels. Smoking is also associated with high blood pressure, poor diabetes control and has additional risks in pregnancy.
Alcohol
Teenagers with diabetes need to be aware of the additional risks of drinking alcohol. Alcohol blocks the body's natural method of correcting hypos, and may lead to them being undetected. The combination of alcohol-induced confusion and a low BGL is dangerous. Reaction times during a hypo have been shown to be reduced. Hypos can also occur many hours after drinking alcohol.
Teenagers with diabetes need to be aware of the additional risks of drinking alcohol. Alcohol blocks the body's natural method of correcting hypos, and may lead to them being undetected. The combination of alcohol-induced confusion and a low BGL is dangerous. Reaction times during a hypo have been shown to be reduced. Hypos can also occur many hours after drinking alcohol.
Whether or not you allow your teenager to drink,
they may experiment with alcohol anyway. Your teenager is advised to:• Drink in moderation and avoid binge drinking
• Not exceed the recommended safe intakes – 2 standard drinks for adult males, 1 standard drink for females
• Avoid consuming alcohol on an empty stomach
• Test BGL regularly during and after consuming alcohol
• Eat carbohydrate foods while consuming alcohol – regular soft drinks or juice are suitable if there is no food available
• Eat snacks and meals on time
• Test BGL before going to bed, eat a bedtime snack and make sure their BGL is above 8mmol/L.
• Don't count alcohol as part of carbohydrate exchanges.
• Always carry some medical identification, so that if an emergency situation arises, appropriate action may be taken
• Have a friend that knows about diabetes and can recognise the signs of a hypo and knows how to treat it
• When combining alcohol with being physically active such as dancing at parties, try to check BGLs. This may not be possible in every situation. Alternatively, check BGLs before going out and then again before bed, to prevent an overnight hypo. Ensure BGL is above 8mmol/L before bed. Asking a parent or family member to do a 3am BGL is another way of preventing an overnight hypo
There are ways of stretching drinks so that it's
still possible to be part of the crowd without feeling pressured to keep up!
• Alternate alcoholic drinks with non-alcoholic drinks such as Diet Coke or lemon, lime and bitters
• Halve the serve of alcohol per drink. Two drinks can become four by ordering wine spritzers (half wine and half soda), half nips of spirits with soda/diet mixers in a tall glass, or shandy (half beer and half lemonade)
• Choose low alcohol beers
• Alternate alcoholic drinks with non-alcoholic drinks such as Diet Coke or lemon, lime and bitters
• Halve the serve of alcohol per drink. Two drinks can become four by ordering wine spritzers (half wine and half soda), half nips of spirits with soda/diet mixers in a tall glass, or shandy (half beer and half lemonade)
• Choose low alcohol beers
Your teenager may feel more comfortable talking to
their doctor, dietitian or diabetes educator by themselves to discuss practical
aspects of living with diabetes (eg. parties, alcohol). This can help your
teenager in managing their diabetes and taking more responsibility for their wellbeing.
Drugs
Drug use, which usually occurs with other risk-taking behaviour, is likely to be experimental or recreational and its effect on diabetes management may be minimal to severe. Tobacco and alcohol are the most common substances which have the potential to lead to abuse. Regular drug use affects diabetes control and this may be denied by the teenager.
Drug use, which usually occurs with other risk-taking behaviour, is likely to be experimental or recreational and its effect on diabetes management may be minimal to severe. Tobacco and alcohol are the most common substances which have the potential to lead to abuse. Regular drug use affects diabetes control and this may be denied by the teenager.
Recreational drugs may:
• Alter awareness and understanding
• Alter consciousness and sensation
• Alter understanding and the ability to make judgements
• Reduce capacity and interest in achieving good blood glucose control
• Reduce interest in routines, injections and meal times
• Reduce appetite and interest in food, increasing the risk of hypos
• Increase the risk of hypos going undetected
• Stimulate appetite (marijuana) leading to high BGLs
• Alter awareness and understanding
• Alter consciousness and sensation
• Alter understanding and the ability to make judgements
• Reduce capacity and interest in achieving good blood glucose control
• Reduce interest in routines, injections and meal times
• Reduce appetite and interest in food, increasing the risk of hypos
• Increase the risk of hypos going undetected
• Stimulate appetite (marijuana) leading to high BGLs
Contraception
As teenagers may not actively seek contraceptive advice, discussion about sexual activity and the need for safe contraception should be a routine part of management for all adolescents. Unplanned pregnancies for adolescents with diabetes can have a harmful effect on the mother and baby if diabetes care is neglected. However, with good diabetes control prior to conception and through to delivery, a healthy mother and baby should result.
As teenagers may not actively seek contraceptive advice, discussion about sexual activity and the need for safe contraception should be a routine part of management for all adolescents. Unplanned pregnancies for adolescents with diabetes can have a harmful effect on the mother and baby if diabetes care is neglected. However, with good diabetes control prior to conception and through to delivery, a healthy mother and baby should result.
Impotence
Fear of impotence is very real in this age group. This is unusual in the adolescent age group and may be minimised /prevented by good management of BGLs. Risk factors include increasing age, duration of diabetes and poor diabetes control.
Fear of impotence is very real in this age group. This is unusual in the adolescent age group and may be minimised /prevented by good management of BGLs. Risk factors include increasing age, duration of diabetes and poor diabetes control.
Complications
Your teenager needs to know about the possible
health effects of diabetes, and this should be relayed in a positive but
sensitive way. Frightening stories of complications and long-term health
problems will not motivate them but rather make them dwell on bad things that
could happen. It may cause them to give up their diabetes care altogether
because 'it won't matter anyway'. Make sure they are up to date with diabetes
education, and that they are well informed about how to minimise their risk of
developing complications.
Screening for complications is usually carried out
yearly, but depends on the advice of your teenager's diabetes specialist. With
a detailed screening program early signs of complications can be detected
before they affect health. The following checks should be performed:
Eyes
Yearly testing of the back of the eye (retina) by an opthalmologist or trained optometrist is advised.
Yearly testing of the back of the eye (retina) by an opthalmologist or trained optometrist is advised.
Kidneys
Yearly testing of kidney function by your diabetes specialist is advised.
Yearly testing of kidney function by your diabetes specialist is advised.
Feet
A yearly visit to a podiatrist is necessary to check for pain, numbness, sensation, ankle reflexes and response to pinprick.
A yearly visit to a podiatrist is necessary to check for pain, numbness, sensation, ankle reflexes and response to pinprick.
Blood tests
A yearly blood test to check cholesterol, triglycerides and other associated problems is advised.
A yearly blood test to check cholesterol, triglycerides and other associated problems is advised.
Early detection is
positive because:
• Prompt treatment in many cases results in improvement.
• It warns people to take extra care of their diabetes.
Some doctors perform these tests in their hospital clinics or private rooms. For further information contact your local diabetes centre or specialist paediatric unit.
• Prompt treatment in many cases results in improvement.
• It warns people to take extra care of their diabetes.
Some doctors perform these tests in their hospital clinics or private rooms. For further information contact your local diabetes centre or specialist paediatric unit.
It will help your teenager to receive some
re-education, perhaps with a friend, and to be given some information regarding
drugs, alcohol, contraception and complications.
What does any teenager do with food at this age?
Being a teenager is a time of growing up and
becoming an adult, testing out independence and trying new and different
things. This means that teenagers often hate strict regulations and being told
what to do. This includes being told what to eat!
You may notice that your
teenagers eating patterns change, often this means:
• Missing meals, particularly breakfast
• Eating snacks, especially in the afternoon after school and grazing right up until dinner
• Eating takeaway food after school
• Wanting unconventional meals at different times eg pizza for breakfast!
• Experimenting with alcohol
• Drinking excessive amounts of soft drink
• Having distinct food likes and dislikes
• Eating more than adults - especially teenage boys
• Trying out fad diets
• Missing meals, particularly breakfast
• Eating snacks, especially in the afternoon after school and grazing right up until dinner
• Eating takeaway food after school
• Wanting unconventional meals at different times eg pizza for breakfast!
• Experimenting with alcohol
• Drinking excessive amounts of soft drink
• Having distinct food likes and dislikes
• Eating more than adults - especially teenage boys
• Trying out fad diets
Riding the food merry-go-round... of diabetes
Some of the typical teenage eating behaviours may
pose particular problems for teenagers with diabetes.
Missing Meals
For a teenager without diabetes the result of missing meals and eating at unconventional times is most likely hunger pains, mood changes and snacking on junk food. However, for a teenager with diabetes there is the potential for more serious risks such as varying BGLs.
For a teenager without diabetes the result of missing meals and eating at unconventional times is most likely hunger pains, mood changes and snacking on junk food. However, for a teenager with diabetes there is the potential for more serious risks such as varying BGLs.
Teenagers usually don’t want to appear to be
different from their friends. Those with diabetes may feel resentful that their
diabetes management plan interferes with their social life. It’s common for
teenagers to experiment with missing injections or varying injection times or
food. This may be the age when multiple injections and/or insulin pens are
worth considering. For some teenagers it provides a more flexible way of
managing their diabetes for others it may not be the best option. Any changes
should be discussed with their doctor, dietitian and diabetes educator.
Skipping breakfast
Mornings are not everyone's best times and this applies equally to teenagers. Breakfast is important for good nutrition, concentration at school and managing BGLs. If your teenager doesn't feel like eating, try some of these ideas for breakfast in a flash:
• Cereal and low fat milk
• Fruit and low fat yoghurt
• Toast, such as raisin
• Warm muffin
• Toasted sandwich
• Milo with low fat milk
• Crumpet or toast with banana, peanut butter or honey
• Fresh or canned fruit
• Low fat flavoured milk
Mornings are not everyone's best times and this applies equally to teenagers. Breakfast is important for good nutrition, concentration at school and managing BGLs. If your teenager doesn't feel like eating, try some of these ideas for breakfast in a flash:
• Cereal and low fat milk
• Fruit and low fat yoghurt
• Toast, such as raisin
• Warm muffin
• Toasted sandwich
• Milo with low fat milk
• Crumpet or toast with banana, peanut butter or honey
• Fresh or canned fruit
• Low fat flavoured milk
Takeaway Foods
Takeaway foods often feature heavily in teenage eating patterns. Many of these foods are high in saturated fat and not suitable every day choices. Try to encourage variety in your teenagers eating habits and the better takeaway choices where possible.
Takeaway foods often feature heavily in teenage eating patterns. Many of these foods are high in saturated fat and not suitable every day choices. Try to encourage variety in your teenagers eating habits and the better takeaway choices where possible.
Better takeaway choices
include:
• BBQ chicken on a roll
• Plain hamburger with salad
• Doner kebab and salad
• Toasted sandwiches or focaccia
• Grilled fish and chips
• Asian stir-fry or noodle dishes
• Vegetable based or gourmet pizzas
• Fruit smoothies or low fat milkshakes
• Low fat flavoured milk drinks
• Reduced fat ice cream / frozen yoghurt
• Diet or low joule soft drinks
• BBQ chicken on a roll
• Plain hamburger with salad
• Doner kebab and salad
• Toasted sandwiches or focaccia
• Grilled fish and chips
• Asian stir-fry or noodle dishes
• Vegetable based or gourmet pizzas
• Fruit smoothies or low fat milkshakes
• Low fat flavoured milk drinks
• Reduced fat ice cream / frozen yoghurt
• Diet or low joule soft drinks
Filling them up!
Teenagers, particularly teenage boys, seem to eat extremely large amounts of food. These changes in appetite are normal during growth spurts and need to be discussed with the diabetes team so that insulin dose is matched with food intake. To ensure that your teenager is growing up but not out, it’s also important to encourage healthy ‘filling’ food choices based on wholegrain breads, cereals, fruit, vegetables and low fat dairy foods.
Teenagers, particularly teenage boys, seem to eat extremely large amounts of food. These changes in appetite are normal during growth spurts and need to be discussed with the diabetes team so that insulin dose is matched with food intake. To ensure that your teenager is growing up but not out, it’s also important to encourage healthy ‘filling’ food choices based on wholegrain breads, cereals, fruit, vegetables and low fat dairy foods.
Disordered Eating
At puberty, teenagers experience a growth spurt, weight gain and significant changes in body shape. This can cause some teenagers to become very concerned about their appearance. Appetites will increase during growth spurts and insulin requirements will vary in response to hormonal changes. BGLs can be difficult to control and it’s important to seek regular and appropriate advice regarding changes to diet and insulin regimens.
At puberty, teenagers experience a growth spurt, weight gain and significant changes in body shape. This can cause some teenagers to become very concerned about their appearance. Appetites will increase during growth spurts and insulin requirements will vary in response to hormonal changes. BGLs can be difficult to control and it’s important to seek regular and appropriate advice regarding changes to diet and insulin regimens.
Preoccupation with weight most often occurs in
girls but may be present in boys. Dieting behaviours are common and in some
cases eating Disorders can be the result. Fad diets can be harmful due to their
variable carbohydrate and poor nutrient content. Diet pills are sometimes seen
as a quick solution but have side effects and are not recommended. Encouraging
teenage girls in particular to remain active in high school can help improve
body image and assist with maintaining a healthy weight. Advice from a
dietitian can also assist to identify and manage weight problems.
Warning signs of an
eating disorder include:
• Preoccupation with food
• Converting to vegetarianism
• Skipping insulin injections
• Extreme weight loss
• Wearing multiple layers of clothing (to cover what is perceived as fat)
• Trips to the bathroom after meals or snacks
• Food restriction followed by binge eating
If you are concerned your teenager is at risk of an eating disorder, seek the advice of your diabetes team
• Preoccupation with food
• Converting to vegetarianism
• Skipping insulin injections
• Extreme weight loss
• Wearing multiple layers of clothing (to cover what is perceived as fat)
• Trips to the bathroom after meals or snacks
• Food restriction followed by binge eating
If you are concerned your teenager is at risk of an eating disorder, seek the advice of your diabetes team
Source: http://www.diabeteskidsandteens.com.au/parents_and_carers_5.html
